Monday, June 27, 2011

A better day...

Calm was restored more quickly than I thought after my moments of panic. I woke on Saturday believing entirely that my trip to the on call gynae service was a dream. I discarded the small panty liner with a light brown smudge on it and got a flash back of the linen bin full of blood stained gowns and towels in the linen trolley from the real emergencies. The bleary-eyed Doctor with pillow creases on his cheek asking how much blood I had lost while I tried to explain that there was no blood but a hint of brown maybe, I had nothing to show but how important this was, especially as I may have deadly food poisoning...2 + 2 = ?disaster?

I picked my pregnancy book up again and found something useful about sensitive cells in the vagina causing spotting after intercourse or bowel motions but describing something more obvious than my meagre findings. Things moved back into perspective as I remembered the heart beat and the closed cervix. Also, a very uncomfortable internal examination but despite this I have had no more colourful PV loss. Maybe my body wasn't letting me down after all. The same book explained that gastroenteritis was not risky to the pregnancy alone, more the effect of resulting dehydration and therefore seek advice after 48 hours, if not tolerating fluids or you have a fever. So actually 5 hours of nausea, a bit of vomiting and one episode of diarrhoea didn't seem like the end of the world.

I wrote a few bits down in a post on BC re. above experience, fear and frustration that I seem alone in compared with the ladies sharing a due date in December post IVF online and got a lovely response from a handful of women, many with pregnancy number two, sharing the fact they did not shop until post 24 weeks for the baby, never stopped knicker watch ever, unless the baby had moved within an hour and one lady didn't announce until 30 weeks on FB. I felt much better after that, I have to say.

Happy news re. the lady with a high risk of Down's that I mentioned has also had the all clear. Her risk was very high 1: somewhere-in-the-teens but the official tests came back negative and she passed the risk stage of m/c post procedure, she says she would never, ever have the screening again. I can imagine how that would feel. For me it's worth the gamble because to be low risk is one more encouraging sign. I know I start at 1:350 so I'm looking for a reduction in that to make me happy. Still a week to go before the results.

Today's picture is of a Mother and her son on 'the world's slowest ferry'. The little boy was very fidgety and grizzly and his Mum was tired, eventually she pulled him to her and they both slept for about 10 minutes so it was a perfect opportunity. Sometimes I consider giving these little sketches to people but wonder if it would feel weird to think someone had been watching you without you knowing, a bit risky maybe. Anyway, I remember how I felt when I sketched it, not jealous but envious and hopeful that I might have a moment like this one day and that if I did I hoped I would appreciate it and remember it rather than the hard work and temper tantrums.

Saturday, June 25, 2011

From the best day so far to just dull, boring, repetitive stress...blah blah...broken record alert

After climbing in to bed following my last post, I opened my first pregnancy book. A friend passed it on to me who is in her 2ww after a 1st failed cycle so I hope to pass it back to her very, very soon. I had just given up after visiting the English bookshop and found just one book "What to EAT when you are expecting". So typical here where there is a famous obstetrician who puts women on 1500/day calorie diets. Most pregnant women wear skinny, white jeans and sport a basketball sized bump until EDD.


Diet has been an issue for me, more in an effort to get enough nutrients in (antenatal vitamins aren't recommended/widely available) as there are a lot of do's and don't's which vary culturally and I found it very hard to find anything to eat here. Partly because I can't read all the labels, I already have some food allergies and as I have no toxoplasmosis antibodies Dr P said, if you're unsure how your meat/veg/fruit is prepared...don't eat it. So I ate some well cooked chicken for the first time in the evening and I've eaten more of a variety of foods since passing 12 weeks so I expected a bit of 'gastric upset' but at 03.00 I woke and vomited violently, hourly, finally with some diarrhoea and I showered and dressed and went to queue for the GP. He said 99% of the time this will not harm your pregnancy which was not the 100% reassurance I was looking for. No scan, no heart beat just that I had no fever or pain so try not to worry. Diet prescribed of meat, plain rice, plain pasta and jelly plus other clear fluids for 3 days....so...not only can I not face anything from that list but I feel so guilty that the baby is getting nothing of value. I finally caved and got the standard antiemetic they prescribe here which helped ease the nausea enough to eat marmite on toast without butter. Not on the 'si' list but not on the 'no' list either.


I didn't have much more D or V yesterday but woke in the night feeling crampy and noticed a pink/brown tinge on the loo roll. WHY WHY WHY. I got dressed and took N straight to the Hospital with my antenatal card. I just can't watch and wait any more or google...I need to know. It was 5.30am so no point calling the Dr or attempting the number on the back of the card (I can't even order delivery ice cream). I was convinced I'd lost everything since the D and V, I added 2 + 2. 


It was an effort to work out the system at the hospital which is virtually empty at that time of night. I finally saw a very junior, brusk doctor who started making odd calls to a superior saying I was 30 weeks, despite my card info, he finally realised. Fair enough, 30 and 13 sound similar in both languages but my lack of bump might have been a clue? All very confusing, mostly in English he examined me, cervix closed and heart beat still there...'just one of those things'. I pushed him a bit about where the blood staining was coming from, it's been gone for 3 weeks and implantation is over (previous reason). He just shrugged, said hopefully the 'bug' hasn't done any harm' and then got back to the real emergencies. I got to see the maternity unit too when I was lost...hmmm is all I can say. If we make it that far I may need to make a proper visit and find out our options for English speaking staff and patient:staff ratio etc. 


For now I'm back on 'knicker-watch' and my food and hygiene obsession. I feel like screaming I'm so angry. I know I'm lucky to make this far but we've been through so much and I'm trying so hard to get some of the experience all my friends seem to have had/are having. What if I'm still getting a little blood staining in my discharge this time next week, when I go to the UK, all the way through?! It's so ridiculously stressful to have to take a taxi across town planning how to break a miscarriage to my Mum in my head and worrying how to say the words to wake N from his sleep that something might be happening. I showed N my latest colour swatch on the loo roll to which he said 'it that it?' but nothing can calm me down.


The heart beat was a relief, always, thank god, thank god but what about next time? I have got a lot more confidence from having a clean, white panty liner these past 3 weeks than the whooshing sound on a doppler which disappears as soon as the machine is whipped away. My next scan is weeks away so I really hope this pale brown/pink tinge does not return. In the mean time this is a huge test and I just have to keep going.

Thursday, June 23, 2011

Endless worries wrapped up in a hopeful bundle.

I'm still so grateful that we may get to have a baby before the end of 2011, after a second (Frozen this time) ET.
I'm so relieved too to have passed the 12 week mark, it felt like it would never happen and I spent the following week worrying about coming off the progesterone and oestrogen. I still get sudden feelings of panic and I rush to look at the clock remembering that there really are no more drugs to take after 16 weeks on the trot.

Further relief came with the booking of the Nuchal translucency USS, yesterday at 12.6 wk. I knew it would reassure me after a few drug free days but as the day approached I worried what it would show. At 35, depending what you read I have a 1:300 or 1:350 chance of Downs and other syndromes. Before these new tests I would have been offered an amnio in the past due to my age but now these non invasive, risk free tests can feed info to a computer and tell me whether my blood test and the NT have lowered my risk from 1:300 or put it up and whether I am 'high risk' or 'low risk'. Results can be very sketchy but most people do it hoping to be a comfortable way in to the 'low risk' or it can be an anxious 6 months with more tests and decisions to make. One lady in the Dec 11 Birth Group has been given a figure of 1:14 and feels she will have more invasive tests with a small risk of m/c (7%) because she just needs to know. I can only imagine how it would feel. I am thinking of her and hope she will get a quick answer. So tough.

This lady had also been told that at 1:14, she has a 93% chance of a normal healthy baby. Incredible isn't it how looking at numbers in a different way can seem so different. 93% sounds great but I'd be devastated at 1:14. I promised myself not to google but I have since and while I felt happy with 2.1 NT I'm not any more. I found posts such as 'at 2.1 it is a little high'...hmm. Plenty of sites say up to 2.8 at 13 weeks and up to 2.0 at 11 weeks so maybe these ladies are at a different stage. The big number seems to be 2.5. Anything below that is...ok but better to be lower. There are lots of ladies at 1.3 - 1.8 which would make me feel better, so much clearer. I really want that 1:300 to change to put my mind at rest about another big what if!

Of course there are many other factors, the bloods can change everything. The scan was worth every peso. The foetus has nasal bones but not clear whether they are all the right segments but that is a small hope. 4 limbs, 4 lovely chambers of the heart with oxygenated and deoxygenated blood pumping around in bright red and blue like in my anatomy and physiology text books. A symmetrical (butterfly) brain, bladder and stomach. And the placenta is front and not a placenta previa so that's good too. Nice to hear the heart beat and not just see the waveform. I got all this info in 30 seconds at the end from a rude, arrogant Doctor who I hope to see for the last time in about 12 days time with the verdict. I have to collect my blood results on Thursday and deliver to him by hand. I will of course open them and have a look.

For now it's time to close google, I've overdosed on reading about NT and antenatal tests and have a mini book in my head. Maybe if my Spanish was better I would introduce the idea of patient information here, a little booklet perhaps...imagine!

Tuesday, June 21, 2011

ILCW virgin

Hello...I'm 35 and living in South America, missing England and planning on having my first baby here in December following (ICSI in January) a FET in April. I avoid naming the country or city I live in as I have promised my husband N that this blog is very private (not easy to find on Google) but I will say it's the land of steak and Malbec and of course Tango, so now you know. It would be lovely to hear from anyone at any stage of treatment, pregnancy or parenthood.

I think I need to create a post like this for people to find when the visit my blog after I leave a comment on their blog, presumably mentioning ILCW so they know they are invited to follow/read/comment on my blog?? Bit confused my this part... 'Every day, leave 5 comments and return 1 comment for a total of 6 comments.' So then I pick 5 different blogs each day and leave a comment them? Not sure what it means by return one...reply if I get a response perhaps? ...we shall see, if not I will have worked it out by next month.

Monday, June 20, 2011

The odd one out

I've always felt like the odd one out, my upbringing was quite unusual. It started to work in my favour when I reached my late teens, I then went on to embrace it. Now, this feeling, can trigger a lot of insecurity. Not being able to conceive without reproductive medicine (as a couple) has resurrected a lot of dark feelings and memories. Throw in living abroad with a poor grasp of the language and everything feels foreign.

My 12 week scan was every bit as special as the others, more reassuring to see real moving limbs than the little 'grey shrimp' with a flickering heart this time. It felt a very personal moment despite the dildocam and I requested N's presence too. This was his first glimpse of the tiny one but also of my legs in stirrups and I think  that made it extra surreal for him. I had to also request a fuzzy image which the Dr downloaded to a memory stick and emailed. I think here people wait for the next scan, he seemed surprised at my requests but I couldn't bear to leave again without a real picture of the mysterious goings on inside. I decided to not see Dr P at the lovely fertility clinic any more but at the normal place, even though both are covered in our health plan. I will still be the bumbling foreigner having everything repeated 3 times at the reception desk for the amusement of the waiting room but I hope this will restore some normality.

I am now one of 20 people on a private FB group that branched out from BC. I'm the only one who didn't 'whoop whoop' after my scan, I just added a little note that all was well on an old thread and sent some personal emails to my Mum, sister and a friend. I don't feel 'whoop whoop', words that I know express excitement online like LOL means 'that's funny'. It's a bit like speaking in Spanish, I don't really feel I'm saying what I feel. I feel really protective too about our news. I feel like I'm not ready for any announcements either. I know if I did 'whoop' on BC or FB that no one would mind as I don't mind when they do...it's just it feels so alien to me. I have felt very nervous coming off the hormones too and that is holding me back a little. It just feels strange that the other 19 people who have all conceived with similar difficulty are choosing baby names, buying baby clothes and discussing breast feeding. My mind wanders back and forth from now until December and all the things that lie ahead. I'm just still taking small steps, smaller than most it seems. Interesting find on BC, I searched a few things on the regular 'December 2011' group and came across a thread called 'Has anyone else not announced yet?'...there were many women in week 12-20 who were hiding in floaty tops and still hadn't got used to the idea that they really were pregnant, let alone that a baby was on the horizon so I felt more at home there for a while.


Homesickness



Most of the threads I am finding information on these days are about shopping and the general order of antenatal care in the UK. The postal service here doesn't work...no exaggeration so I can't order anything and most things you buy here, clothes for example, are made here and are very poor quality at a high price. Food is what I am missing most. While I'm strong believer in eating what a country does best when you are on holiday it's different if you live abroad. N made a trip to Mauritius recently and managed to find bacon and baked beans. Incredible. Even when I have spent time in Bangkok, Hanoi and Hong Kong to visit friends I have found a better selection of food. Expats took me to local cafes doing a full English or a nice Italian style pizza when you need a change and of course the traditional food is so great. I always want to return home for Marmite though and N managed to make a dash to a big supermarket in Johannesburg on his way back to South America with find 3 jars. This is keeping me going. My last empty jar ended up being kept because I couldn't accept it was truly empty and I sketched and painted the final scrapings, several times.

I feel so far from home these days. It's 6 and a half weeks before we return for our annual visit and I will be eating as much asian food, spicy food, fish, humous and chocolate without anti melting agent as I can. In place of cold white wine which I must avoid I will enjoy squash that is not 'red/orange/yellow fruits flavour' and doesn't come in the form of powder, cranberry juice and a wonderful selection of tea. This country does have the best meat and red wine in the world (in my opinion) but that's the last thing I want at the moment. Marmite on toast, with butter NOT cream cheese, a twix and a cup of decaf earl grey would go down a treat!

What are the odds?

I do feel some relief, as predicted, to reach 12 weeks and 'pass' the 12 week scan. Many other feelings have taken me by surprise. I am often grappling with my anxieties and trying to decide which ones are rational and which ones are not. Things could still go wrong, of course, but the odds are better. As I like to remind myself in taxis/trains/buses to the airport, I have a greater chance of dying/injury on my way to the airport than on board the plane. It helps a little when I feel the odds are in my favour.

Back in December, 2010. N and I sat in the same room I had my 12 week scan in and were told we had a 45% chance of a pregnancy from a cycle with 2 embryos and a 30% chance of a live birth from that, with a 10% chance of twins. An image popped in my mind thanks to a wise Doctor I used to work with who used to tell families..."Imagine 10 (or 100) people at a bus stop....if we operated on all of them...X amount would develop X complication". At this time, I sat and imagined 9 other couples in a waiting room and wondered if we would be the one couple called through to news of twins or would we be left sitting. I found the odds hard to bear during the 1st cycle (that failed) but quite comforting when I was able to step back and see the bigger picture and imagine being in the 85% that would get a pregnancy from 3 cycles. Those odds were good.

I avoided looking at odds once I tested positive post FET but I saw a few numbers drift by on BC. Then, after the 6.6 scan with heart beat detected my Dr P gave us a new number...85% chance of a live birth. This is a great number. This is how it felt. Not that we were home and dry or had 'beaten' infertility as some people feel. It felt like the next step in the treatment, a real step in the right direction. Finally the odds were in our favour. And so I oscillated between feeling positive about these numbers and feeling myself becoming part of the one-and-a-bit couples left in the waiting area that didn't make it. After all, 4-6 hourly hormone tablets/pessaries and spotting, 35 years etc...hmm. But I had real hope, more than we'd had for years.

Now the percentage of losing what we have is minuscule and we have new odds of abnormalities and complications to face. These are the odds I've seen clients and patients deal with in my work and issues I've given a lot of thought to them but they feel welcome dilemmas compared to what we have faced recently though no less stressful. So as I sit in the imaginary waiting room with 100 other couples wondering if I will make it through the next door and I start to panic, I consider all the other odds, like being hit by a moving vehicle (it varies but where I live it must be higher than average). It provides a few rational moments at least in the emotional journey.

Tuesday, June 14, 2011

Doubt

Not only am I worried re. last post but I'm in such a state today. For all the 18 months I've been living out in S America, today...I just want to go home... to my local GP. In reality I'm lucky. I have a health plan here and have a lovely Dr (gynae/fertility) who did our fertility treatment outside out health plan (we had to pay) and is now doing all our antenatal care (free) as part of our health plan. He is only ever a phone call away and he is my midwife/early pregnancy unit/first port of call all rolled into one. 
So while I'm not 'missing out' on UK stuff (except freebies) occasional differences make me panic. Like...he wants to do a smear. The one inspection of my ladies bits that was forgotten pre treatment. I am supposed to 'drop in' this afternoon for one, with him. I haven't felt comfortable with it and finally got on google last night. Apart from the usual horror stories 'I had m/c 2 days after smear' (with no dates, history or evidence) there are currently no known contraindications to a smear during pregnancy, according to UK, US, Australia. Best article researched 1900 women. (6 hours of google).
The only arguement not to have one is that cells change so much in pregnancy it throws up false abnormal results and treatment cannot take place during pregnancy anyway so in the UK overdue smears are usually delayed until 3 months post delivery. Also the UK still only recalls women every 3 years (whereas it's more frequent in other countries). One other reason (according to UK/Oz) for testing in pregnancy is that sometimes it's the only time to catch women who do not attend routine smears.
Here, it's once a year, so that's why my Dr feels I need one as my last one (normal) was 18 months ago. I did have a virus in my 20s that suggested annual smears would be a good idea but they've always been fine at 3yrs. I had a cervical polyp removed in Feb (grew due to IVF drugs). Maybe he has other reason, I will grill him today.
I found lots of literature from US and Australia that says it's very routine there to have a smear as part of antenatal care and that it can pick up early signs of changes and infections that may be passed on to a new born via the birth canal.
I don't really know what I'm looking for in a response to this post. I will speak to my Dr and tell him why currently I don't want it done. It just feels hard to turn down something that all the other women in this country have and see as a normal part of their antenatal care. If I was born here all my friends would have had one and I probably would feel guilty turning down this test.
My 12 week scan is looming at the weekend too = stress +++

Monday, June 13, 2011

Online support

I'm managing to distract myself in the 1ww to the 12 week scan. I've been feeling better generally. I don't feel so absolutely dreadful day and night so that has helped my state of mind but of course I don't want to lose symptoms either as they provide peace of mind. It's a funny place to be in.

WARNING: sad topic to follow.

I have returned to BC after my holiday and found the birth club around my est. due date quite helpful. The group has spread to FB where (I had no idea this was possible) there is a private/hidden group which is v secure. It's nice to put faces to usernames and you don't have to be friends on FB to join the group. It's nice to use each others real names too. Occasionally I get a bit wound up by the posts on BC but generally they are quite sensitive and don't trigger much anxiety in me. There was one saying 'my Dr told me Progesterone pessaries are bad' with no justification or information to back it up. This sort of thing upsets me (see previous post).

Today there was terrible news about one of the ladies who went for a routine 10 week scan where unfortunately it turned out the foetus had stopped growing at 8.6 weeks. Devastating news and a shock as there had not been any warning signs for this lady. I wrote a few useless words of support and spent a moment just thinking of her and her husband. Then...back to me. This news has completely rocked me. My last scan was at 8.6 and I've been persuading myself that there's still something going on in there and chances are all is OK but my goodness. The tragic story from someone else's life is a reminder that anything can still happen.

I'm sure as things my end are confirmed I will feel more confident and no one is to blame for this. I did beat myself for going back online after I felt better staying away but I can't hide. I sat opposite a friend the other day who casually said '...and she had 3 m/c all at 12 weeks'. I have to learn to hear these things and get on with it without becoming incapacitated by worry.

Thursday, June 9, 2011

Shh...I'm mentally flying this plane!

Amongst my many fears is flying. This is a bridge to cross once I know how my 12 week scan is (8 days to go and counting down every 6 hourly progesterone suppository to get me there). People often ask me what I'm afraid of? Take-off, landing, turbulence? It's the moment it starts down the run way, the engine gets louder and you feel yourself pinned a little tighter to your seat. From this moment on...I am out of control.

I imagine jumping out of my seat and walking uphill towards the airhostess who might be duty bound to restrain me, or perhaps at this stage I would be ordered to sit down and she would call the Captain (locked in his cabin) to warn him a passenger is on the loose. The fact is...I can't get off. On a coach or train I can demand that we stop. A boat? Dunno...launch a life boat? At least I can walk on deck and breath the oxygen at a normal altitude.  Short flights over land are not so worrying either. My first ever flight was London to Belfast and a passenger had a heart attack half way and we landed so fast it was incredible, there was the ambulance, ready and waiting. But long haul....over the desert/mountains/ocean...makes my head spin.

I finally got to grips with this when I flew alone, London to Bangkok. Fresh from the last page of Allen Carr's 'The Easy Way to Enjoy Flying' I felt reassured by each chapter, tackling the many 'what ifs'. My favourite...'what if a wing falls off? Well, then you crash but this has not happened in the history of commercial flights' (or similar). Once on board the air hostess announced a delay and asked if anyone would like to meet the Captain. Well, according to Allen Carr this can be v useful in overcoming one's fears. I jumped up and was led through the cabin by a smirking air hostess. I found myself standing behind a small child was showing the pilot his teddy and explaining he was called Joshua and he was 5. I turned on my heal to find a queue of parents and kids so I had to walk in and say 'I'm **, I'm 27 and I'm a very nervous flyer'. It did help. I was still terrified mid air but considered if I could keep mentally flying this plane all the way, I managed 2 hours then my feet relaxed to the ground, I sank back in the chair, I stopped sensing every movement. What if...? What if indeed. What could I do? I gave in, I let go, I slept.

I am getting these moments of giving in now, there are so many what ifs that I can't control. I try to follow advice. I take my medication every 6 hours. I appreciate that I'm not spotting right now. I try to let myself fall asleep, enjoy a film or book, enjoy a fantasy that this may actually work out. Let go of the things I can't control in the world.

Monday, June 6, 2011

Hola

I think I've lost my tiny blog following all together in my attempt to shake off a few unwanted followers. I plan to get involved in the comment week that everyone has gone in for in the last few months, I feel I should make more effort and be braver to share and not take it personally that I don't get many comments which sometimes puts me off getting the blog out there, I always wonder why this would be of interest to anyone but before my motivation was for my friends who were following, is was more personal than FB and more discrete but as I'm not ready to announce my pregnancy yet I'm trying to use it anonymously as it's quite lonely being pregnant so far from home when you can't tell anyone and I have the scars of IVF, a failed cycle, mc and my recent spotting. None for 10 days now...please, please stay away!

It's like I posted a while back on BC and said I was finding the uncertainty and spotting hard to deal with, mentally, I was really clear that I had been fully checked out and had been told was just one of those things, it hadn't changed and had in fact got better but generally I was afraid, lonely and I talked a bit about being an expat and how things were different here. My response from half a dozen people was go to an EPU if you're worried. This was not helpful as if I went to an EPU every time I worried I may as well set up camp in the USS room, insert dildocam until HB detected and wait...I suppose I was more hoping to hear I wasn't alone or other ways people deal with uncertainty. The comments were well meant of course.

I'm hoping the brown spotting will not return and that the 12 weeks scan will bring confidence and allow me to tell close friends and family. This will be followed by lots of apologies for basically disappearing and turning down every social invitation I've had for the past 6 weeks. I did so well post FET, I was out and about, even at 5 weeks but by week 6 I've been permanently 'sick' and useless. Not that I'm complaining about symptoms, they are my best friend these days, very reassuring.

For now I'm booking tests for early signs of abnormalities and this is a welcome distraction from my current 2ww. It's scary but in a different way to the uncertainty of IF. And while the old dildocam without printer and my very cautious 'let's take it little by little' words from my Doctor seemed to have robbed me of the tearful joyous 6 week/9 weeks scans that I keep reading about.... in it's place I have a 'carnet perinatal', it has all my measurements, due date and numbers to call in an emergency. It's something solid to hold that says 'you're pregnant' and that makes me v emotional every time I see it. From joy, relief, tearfulness and fear. It changes moment to moment.