Because he'll be amazing

While also gearing up for exams, H is in the midst of marking term papers for his 80+ students this week. It's a not insubstantial task, this pile of paperwork; but somehow he manages to pour limitless stores of commitment, passion, kindness and genuine understanding - not just for the intellectual exercise, but for the young lives behind the often clumsy, sweet, and occasionally unintentionally humorous essays. It is more than just paperwork for him.

Some of these students he has taught since they first entered university. Some he is supervising as they prepare their dissertations, their first substantial pieces of independent research. Some he is helping to prepare for their steps into graduate school and the wider world beyond.

He guides. He invests time and concern. He encourages.

He swells with pride, a little, when they succeed. He cringes with angst when they falter, hoping it doesn't sting too much.

This gentle, patient, loving soul I married.  

Yes, fatherly. It is fatherly guidance and concern and encouragement he pours into these tasks, these students.

I hope they know how lucky they are.

I hope that one day soon, he'll be imparting that fatherly touch not just on his students, but on the tiny life we will grow and nurture and one day set forth into the wide world.

To learn and think and falter and laugh and write clumsy essays of their own.

World's best teacher,  Dad-in-waiting. Source.

Avocado, coconut and lime smoothie

Time for a break from all the assisted reproduction/medicated cycles/baby making talk. My head is spinning with thoughts of what the future holds and so for now, I'm going to do what I often do best with overwhelming situations: hide my head in the sand for a bit longer let things take their course until Wednesday when I go in for my progesterone levels. Let's talk about more mundane and pleasurable things for a moment.

I'm now in week four of my new gluten free diet and I have to say that there hasn't been much of an adjustment. I'm not a big bread/cake/muffin person, and I've found awesome ways to incorporate starches and flours typically found in Asian and African cooking, so my experimentation with international cooking has become more and more the norm. Fun! I've lost weight, (which wasn't my goal but it certainly doesn't hurt), and am feeling generally a bit lighter and more energetic - yay!-  so I think there's something to this, whether or not it will aid in the improved functioning of my lady parts.

My only real challenge has been breakfasts. I'm not really a breakfast person, per se, so I have a usual rut of going for a slice of wholegrain toast and peanut butter, or oatmeal, both of which are now off the proverbial table. I have a stomach that is extremely vocal and vociferous in its demands for regular nourishment - I'm talking disruptively so.* So skipping breakfast is not an option whether I'm hungry or not. Since going gluten free though, I've had to rely on lots of smoothies to keep me going and my fruit choices are growing rather monotonous.

I need to be more adventurous: enter the avocado. I loooove avocado, and at my favourite Vietnamese restaurant in Toronto I always used to order their avocado shake, so I thought I'd attempt something along those lines. I also had a half used can of coconut milk in the fridge, so I chucked that in, and a star was born. Oh my lord, you guys how has it never occurred to me to pair avocado and coconut before now? I want to eat this for breakfast, lunch and dinner, in a variety of combinations. Breakfast this morning was this smoothie using half an avocado and whatever else I had in the fridge/fruit basket. It has the added benefit of being vegan (which I am not, but cutting animal fats down to such brilliant effect is never a bad thing).

Avocado, coconut and lime smoothie

•  1/2 a ripe avocado
• one kiwi fruit, peeled and sliced
• 1/2 cup of coconut water (or milk, if you want it thicker)
• juice of 1/2 a lime
• a handful of mint leaves
• shaved coconut if you want some texture

Throw all this stuff in a blender and tell me it's not amazing.

*  In university I had one morning lecture that I couldn't reschedule to a more civilized hour, and once, in a hurry, showed up without having eaten. My stomach was typically clamorous that day, to the extent that the lecturer stopped talking at one point, glared at me three rows back, and asked if I'd like to step out for a snack. At which point I wanted to hide under the paltry little writing board attached to the arm of my seat, and made a mental note NEVER to attend an event of any kind without first feeding the beast. I really am ruled by the whims of my stomach.  H finds something oddly adorable in my (foodsexnow!) complete deference to my lizard brain, but I'm not sure others see the charms.

Prescription: a long and winding road

That kind of sums up how I feel about our appointment at the subfertility clinic yesterday.

Starting off with the good stuff, I liked the feel of this clinic very much. When we were called in to see the doctor, having hardly waited at all, she had all the relevant information (including my misplaced bloodwork) to hand. She has already been in contact with the lovely OB/GYN regarding his investigations, and they appear to be genuinely well coordinated and organised here (unlike the nightmare that is my GP's office, and I am oh-so-relieved to not have to get further investigations handled there but at the subfetility clinic itself). Unlike our horrible experience with the last subfertility clinic we consulted, these guys will continue to monitor me closely with each new cycle, and develop a protocol accordingly. All good.

It's the current protocol they're suggesting that leaves me feeling a little deflated. In sum, she believes that my odd pre-menstrual spotting and general weirdness these past few cycles may indicate they have been anovulatory. On the one hand, I'm glad someone is finally paying attention to my concerns over this (shocker: I may know my own body as well as any doctor!), rather than fobbing me off with the usual 'these things can happen' auto response. But this also means that she wants me to complete two cycles with closely monitored bloodwork to first decide if I'm ovulating at all. If, from my progesterone levels, it appears as though I may not be, she then wants me to start three rounds of clomid. And then if, after three cycles, we haven't yet conceived, she'll refer us on for IVF. Once that referral is made, they promise a maximum wait of 18 weeks before an actual IVF cycle would go ahead.

This feels like a long and circuitous route to what I increasingly fear will be our only shot at a biological child. With this protocol, we're looking at four + cycles before even getting on the wait list. That means I'll be approaching my 39th birthday before we can even think about moving forward with IVF.

And then there's the rationale for this course of action: You've had three pregnancies, so you can actually conceive quite easily. (Easy obviously being very much in the eye of the beholder here).

I know it's terribly sulky and irrational, but right now it's hard not to feel like we're being penalized for having had three losses. Although I do realize that we're lucky to be able to conceive, to even ever have the chance to try on our own, (and although I know some women who have never had the experience of seeing a positive pregnancy test may find it difficult to relate), I would hardly call three miscarriages a spate of good fortune; yet, in terms of assisted reproduction, that's how the medical profession sees it. In terms of making babies that are too fragile or poorly built to even survive in the comfort of my perhaps openly hostile and not at all comfortable womb, as we all know, I am actually quite talented.

Logically, I know this makes some sense, this wait-and-see approach. (Doesn't it? Feel free to jump in if you have other ideas; I'd actually be grateful for the insight.) But there are so many things for us to have to process with this. I'm worried terrified about my age being an increasing factor with each passing cycle, so there's that. H's 'good' sperm analysis results have always been borderline good, so we know we don't have ideal conditions in any case. I admit that I continue to have substantial reservations about crazy juice medicated cycles; about the havoc they could wreak on my already wonky system, about their sperm killing properties (c'mon, we all know Yahoo answers is a perfectly reliable source of medical information). Also, seriously...we've been trying for three years. There comes a point when no amount of humour or prosecco can sustain a truly fulfilling sex life - or our sanity - through an indefinite period of super sexy no pressure let's have fun! timed intercourse. Our marriage, our emotional wellbeing and our psychological integrity need a break already. Please?

H and I are still thinking through how we feel about this, and whether we want to take any further steps in another direction; we have the time to contemplate these possibilities, it would seem. I also think this doctor is quite cautious in terms of wanting to go the least invasive route, which I can understand. However, with our history I don't think we really feel in a position to err on the side of caution with our timelines. Is it totally insane that my brain already calculates that, even should a pregnancy occur for us, we'd also have to factor in the time for another loss and the recovery that would entail? Well, yes it is insane, clearly; but there you have it. A serious mindf*ck

***************************************

I thought of using this picture to illustrate (all too literally because I'm lazy and uncreative with my metaphors) what it feels like - today at least - to be looking into our baby-making future:

It was taken several years ago on a summer hiking holiday we took in one of our favorite corners of Austria, a small town on a crystalline alpine lake, nestled in the countryside between Salzburg and Innsbruck. The area is home to an infamous stretch of circuitous, thrill-and-vertigo-inducing alpine road. The road is winding and you never know when the next curve will fly at you, seemingly out of nowhere, so you've gotta keep your whits about you. You're way high up, it's scary, and occasionally nausea inducing. Frankly, it's sometimes downright dangerous. Apropos, no?

Well anyway, then in the course of sifting through folders of old holiday albums on my laptop to get to this, I was reminded that about thirty minutes after the photo of the road was taken, as we reached our destination, there was another image. This is the view that greeted us:

Will the view at the end of the road make it all worthwhile?

OK, I'll give you a moment to groan inwardly at the schmaltzy, juvenile sentiment of this photo montage. Just go with it people; I'm trying hard to look on the bright side right now. I need to keep nurturing my invincible spring. Or, uhhm...maybe move to the Alps? I'll figure it out and get back to you.

All's well that ends well...

...but maybe for the moment we could let up on the constant onslaught of endings and beginnings and surprise new endings. Pretty please? I feel a bit like I'm emerging from a tumble dryer, and I'm having trouble keeping my thoughts in order these days.

As a brief postscript to my swearing, venting rant last week, I want to thank you all for your commiserations; your own swearing and incredulity on my behalf, virtual angry fist shaking, copious use of exclamation marks (on an occasion which surely called for them), and general sympathy gave me the raging energy that fuelled the twenty minute living room dance party (to Muse, The White Stripes and The Ramones, in case you're interested in the playlist*) which eventually allowed me to blow off the last of the accumulated steam.

Also, in light of some of your comments (particularly readers in the US), I admit there's a part of me that feels like a gigantically ungrateful, whining moron. You see, with the system of nationalized healthcare available here in the UK, regardless of the quality of care we receive, there are no bills to be paid, no insurance companies with whom we must negotiate. We pay nothing for any of it: not the doctors visits, nor the invasive procedures using medical technology worth thousands, or even, if we end up going that route and stay within our current county, for up to three IVF procedures. There are small standardized fees for prescription medications, and that's it; all the rest comes from the taxes we pay anyway. I know we are truly blessed to live in a country that considers this to be the right of all citizens, and the responsibility of the taxation system to provide. I know that it is an amazing gift that the considerations over IVF, for us, do not include the usual concerns about the financial burden involved. For all the complaining I have done about my care, I am truly grateful to the NHS - warts and all - for providing in this way. Coming myself from a country with high quality universal healthcare, it's an ideology I strongly support. And no, I don't think that this nationalized system in any way explains the errors or incompetence I've experienced. Because sadly, I've read too many of your experiences and know all too well that healthcare providers often demonstrate disinterest, a total lack of empathy, or general incompetence; public health has no monopoly on this. It's all about finding the right people to fight in your corner, and so far I've had some hits and some (ok, a lot of) misses. No-nonsense Nurse Julie's interest in my case, and the swoon-worthy bedside manner of our high risk OB/GYN are proof of that. I suppose in healthcare as in any profession, those who are truly passionate and excel in their work to the benefit of those around them are rare gems. So OK, I'll stop moaning now, for a bit. Perhaps I needed a reminder of just how good I've got it.

Having got that out of the way, let me bring you up to date on the situation. In a bizarre sequel to said careless-human-error-fuelled rant, and having decided that I would not deal with the incompetent schmucks who messed up my bloodwork in the first place, I booked a follow-up on Friday with the lone voice of professionalism in that office, my favourite, gruff, get-the-job-done nurse. So here's the kicker: when I got to the office, she had reviewed my files, chased down the lab staff, and lo and behold, my numbers were actually there. She scratched her head, while I proceeded to lift my jaw from the floor, so that we could get on with business as usual. Although there were obviously some major filing/record-keeping/human tissue disregarding fuck ups involved, no one has any idea why I was told my bloodwork had gone missing on Thursday, save the possibility of a rogue nurse sabotaging patient records. To be honest - aside from not wanting to contemplate the scary levels of ineptitude and any ramifications therein - I didn't stick around for the answers. Small triumph! I have my bloodwork results! I made sure to get hard copies: lesson learned. So I will not, after all, be seeing the specialist empty-handed.  

Though in the interim, it sure helped to be able to blow off steam here and on the livingroom dancefloor. And now I'll stop swearing too.

***************************************

In other news, there isn't any.  And this is kinda the source of that tumble dryer feeling, I suspect.

I find myself wanting to blog, but each time I try to form a post in my head I end up at a loss. The fact is, there is not much going on, though there may be much in the works. We have our subfertility appointment on Wednesday; perhaps it will provide some clarity, though I doubt it. There may be movement on the job front for H, which means there may be another transnational move on the horizon.We may be on the cusp of pursuing IVF, but until we know where we'll be and what we'll be doing, there's obviously not much we can concretely plan towards. Although we continue to try, I think that emotionally, a huge part of me has conclusively given up on the idea of another natural conception ever happening, so I don't really feel like I have that to obsess over at the moment.

Maybe, maybe, maybe...I feel like we're in a state of total limbo, which for a restless do-er sort like me is a challenging place to be; I find it drains my energy in a way that being truly busy never does. And even though I'm kinda unemployed right now, I'm continuing to work with several students privately, so my time is still not my own. I can't take any action, plan anything, prepare for a particular eventuality. No real, definitive endings or beginnings in sight. For now, all I can really do is ride it out.

I guess all my playlists are going to be getting extra airtime in the coming days.

* I have an actual playlist entitled Angry Dance Party. Such is life, though it usually does the trick.

Fuming (and swearing)

Twice.

This is the number of times in a row that my GP's office has fucked up my CD 3 bloodwork.

Last month I went in on the same day as my very positive (but clearly worlds apart, experientially speaking) appointment with the specialist. I waited for the results, and I waited. I'm accustomed (by now) to having to chase my own results if I want to stay in the loop. OK, so far so usual; I called and nagged. Results still not in, they said. I waited a few days more and called again. Still no results, the receptionist said at first, but then: Oh wait! We have them here after all and I can just pop them in the mail to save you having to make an appointment. I thought this was very helpful and thanked her for the trouble. Except that when the mail arrived, it was my CD 21 bloodwork from the previous cycle. (Which means that either she hadn't listened or wasn't paying too much attention to my charts). In the end, I happened to be passing by their office to pick up a prescription for H, so while I was there I thought I'd just rectify the mistake and pick up the correct results (a full month later) in person.

When I asked for these, the receptionist looked at my chart, started acting cagey and mumbled something about having to make a phone call. Long story short: she hangs up the phone and tells me that the blood was not tested because it had clotted by the time it reached the pathology lab. Now, I'm no lab technician, but I have had literally hundreds of vials of blood taken in the course of my life, and this is the first time that it has ever misbehaved in this particular way. I'm thinking that either the samples have to be stored or transported incorrectly for them to coagulate to a point beyond testability. (Any medical types out there feel free to correct me).

Oh, and they didn't bother letting me know this because apparently they had the wrong details about which medical practice had ordered the tests in the first place and the message was never relayed. I kept my cool and put on my best ice bitch calm and collected face.  

Why it's lucky I asked then! says I. Because today just so happens to be CD 3 for this cycle, meaning you can march me straight in, drawn more of my close to boiling blood, and still get the results in time for my appointment with the subfertility clinic on the 24th. All smiles, I was. I even joked with the nurse about not losing my blood this time.

(Ha! The irony! The horrible accuracy of hindsight!)

So you can imagine that this morning when I received a text message saying that I should contact the GP's office to discuss my blood results with a nurse, a hint of oh for fuck's sake, what now?! trepidation crept in. I called and was put through to a nurse. And she proceeded to tell me that my CD 3 hormone levels (for this, the second cycle in a row) were not tested because...[wait for it!]...the vials had been labelled wrong.

They put the wrong fucking surname on my blood, and realized only too late, and had to ditch it. And now I'm at CD 8, which means too late to catch those hormone levels this cycle, in time for our upcoming appointment with the specialist. Also, given the weird variance in my last two cycles, I feel it would have been worthwhile, not to say reassuring, to catch the fluctuations at the time.

I got off the phone and was shaking with anger until H peeled me off the ceiling and soothed me. I know it's not a big deal in the larger scheme; but I can't help but wonder, if they can screw up something so simple with such frequency, what hope is there for more monumental health issues? And don't we already have enough on our plates, really? Must I always cajole, and be vigilant and harass for them just to do the jobs they're trained (we can only assume) to do? How much more blood do I have to spill?

And WHY can't I just fucking HAVE A HEALTHY BABY already, like normal people, without all these doctors visits and poking and prodding and blood letting and angry tears?!

 Because at the end of the day, that's really the crux of it.

OK, I feel a bit better now. Deep breath.

Note that second step people. Source.

Everything is going to be alright

When I was a poor student (as opposed to the poor, middle aged unemployed girl I am now), I set down stakes in a particularly cheap part of Hackney in now-trendy east London.

At the time, it was the only moderately affordable part of the city in which a student could find digs. That was before the area's pre-Olympics makeover. It was still a real neighbourhood then. There were no chain stores on the high street. There were still anarchists' and artists' squats in the neighbourhood. The Turkish guys who ran the off licence around the corner where we bought our milk and tomatoes would lend us money for the bus if we were running short. Every Sunday, this big group of Jamaicans who frequented the pub down the street would set up an old steel drum, light a fire, and serve jerk chicken right there on the pavement from their improvised BBQ. It was - at least in my mind's eye - idyllic.

(There were also three times in the two years I lived there that crime scene police tape prevented us from entering our flat four hours on end. The particular stretch of Hackney we occupied became notoriously known as the Murder Mile. It really was 'inner city', with all the connotations that term evokes. Well...I said it was idyllic, not perfect).

Anyway, at the time it was just barely becoming the haven for arts that it is today, and at the end of a derelict old dead end street the artist Martin Creed had chosen to place one of his now famous light installations on the portico of an abandoned building.
 
It read: EVERYTHING IS GOING TO BE ALRIGHT

The building, which has an interesting history in its own right as the 19th century home of the London Orphans Asylum (oh, the historical irony!), was a sight I passed every day on my way from the train station. Sitting at the end of that street I walked past, it's pale blue light would catch my eye at an oblique angle as the twilight was setting in. Located in a forgotten and dingy part of the city surrounded mostly by poor tenement blocks, I was never sure if that neon sign was being ironic. But there was a whimsy to its placement as well, and I have always had a soft spot for the beauty to be found in small, forgotten corners and encounters.

Still, at the time I found something eerie about that work's glowing neon presence. Now I kind of realise, in a whole new, deeper, more grown-up way, that it was true.

Everything is going to be alright.

Infertility schizophrenia: glass half flempty?

You might have noticed, (it was certainly not lost on me, if only in hindsight), that my announcement about moving forward to IVF was unceremoniously deposited at the end of a blathering post touching on innocuous topics like work and the weather. I suppose there is some deeper psychological insight to be had in this observation, about the state of my continued denial or my fear of moving forward, or...whatever. Make of it what you will.

This post is prompted by a post yesterday from Sarah at Fallopian Groove (who it turns out, while I was writing the draft of this post, was having a Very Big Day Indeed - as well as fuelling the fires of what I previously thought were you-could-mistake-implantation-bleeding-for-a-period! pure urban legend - so drop by and give her a little love and encouragement). Anyway, her description of the 'infertility set' (card carrying member here!) - one so apt that I'm tempted to see it as a kind of manifesto - touched on the need for us to embrace being glass-half-empty kind of people.

My trouble is, this whole experience has made me, for one, more than a little glass/liquid-ratio confused. I'm schizophrenic on this topic.

Because I need, on some primeval and self-protective level, to see the glass as half empty as each two week wait hurtles towards its now-inevitable conclusion month after month. This in order to keep my sanity and sense of self-worth intact, to keep from being broken right in half in such a way that no amount of bandaids of chocolate or curling up under a duvet would sooth. I need to embrace the whole this-won't-be-so-bad-your-life-is-great-either-way sense of the inevitable. 

But by the same token, I need, as I am dragged towards another fertile window of super sexy jungle time each month, to see the glass as half-full, to want to keep bothering at all. Not with the sex itself - which obviously we'd have periodically anyway - but with the vitamins and the hurry up I'm ovulating NOW sexiness and the treating my body like a goddess temple that I still believe might be inhabited by a growing baby one day. To keep hoping in such a way that is more than just a painful reminder of what isn't, and allowing for a belief in what could be.   

These two halves of me are in an eternal manichean struggle:

From this could almost certainly be The Month! I can just feel it somehow!

To there is no possible way that this will ever happen for me! Who am I kidding?! 

My problem is that by nature, pre-utterly hopeless less-than-fruitful baby-making attempts, I have never been by nature either a pessimist or very realistic. (I am the sort of girl who booked a one way flight to Turkey one summer in university with no plan, no language skills, only what I could carry in my backpack, and £200 in my bank account; just because I thought it'd be fun to see where it took me, and I just knew I could rely on the kindness of strangers to help guide me. Turns out on both those counts, and on that occasion, I was right. But I digress.)

I think I probably used to be one of those annoying anything-can-happen-if you-will-good-vibrations-towards-you perky people. And although for the most part I'd like to punch that version of Sadie in the face more often than not nowadays, I guess I still need her reckless, bitterness-free, dreamy hopefulness to hang around on the margins at times.

Take this past cycle for example. I started spotting at about 10 days post-ovulation, right around the time I took my customarily too-early-to-tell pregnancy test intended to desensitize me to the inevitable disappointment but just-early-enough to leave room for hope (welcome, once again, to my neurotic ttc brain). Even though this hormonal weirdness was also a part of last month's unsuccessful cycle (and appears to have become a regular thing), coupled with the, er...negative pregnancy test, the annoying, dreamy glass-half-full Sadie beat down my bitterness for a day and forced me to really question my more jaded self. What if this might was the fabled implantation bleeding? (Hey, just because it's an urban legend doesn't mean I don't fervently believe in it at times; just like say, the Sasquatch, or a new Star Trek: TNG spin-off). I briefly wondered if I might not, in fact, be with child.

And yes, I can understand why you'd want to punch that Sadie in the face, but you know what? I also kind of liked the floaty feeling that carried me through that one delusional day, because even if it was deluded I managed genuine joy for those hours, and that fact did nothing to exacerbate what would in any case have been the same feeling of crushing failure and time-is-running-out anxiety that I feel every month.

So it's a dilemma; one that I know does not end, for those of us who have struggled so to get there - and maybe struggled with staying that way - once a pregnancy finally occurs. I'm interested to to know how other people cope. Or am I the only one who suffers from this particular brand of schizophrenia?

What about you bloggy friends? How do you manage the delicate balance of hope versus realism? Have you changed in your outlook over time?

Never a clear winner. Source.