Haisla's Adventures in Endoland

I've been toying with the dangerous substance called hope this cycle.

I guess the reasons for this downright foolhardiness could be listed as follows:

1. I had 3 follicles this cycle (which obviously equals three babies, right? Right!?)

2. My cervical mucus was 'beautiful' on the day of IUI (a direct quote from Nurse Nelly)

3. I am on progesterone suppositories for the first time ever, which should combat any kind of luteal phase defect, should I suffer from such

4. My uterine lining was 'lush'

5. I've been feeling twinges in the lower part of my pelvis where I imagine my uterus to reside since last night - 8DPIUI (although I am a serial twinge-spotter, so perhaps No.5 should be discounted)

6. I've applied for a new job and should I get it, getting pregnant right now would be really, really inconvenient since I would be approx. 3 months pregnant (and probably showing) on my start date (obviously this is all highly hypothetical, since I haven't even been offered an interview yet..)

So there we go. Here I stand, dangerously teetering on the brink of hope. What do you think- should I run back to cover or recklessly jump off the cliff and start the free fall that quite frankly has a 50-50 chance of going either way (i.e. I could crash-land really badly or miraculously find that I've learnt how to fly..)

Having gotten over my little needle rant of last week, I actually had quite a successful IUI on Friday.

One Weds I had two x 18mm follicles on the left side 1 x 18mm on right and a couple of smaller ones floating about.

My uterine lining was at 12mm on Weds (I think that's good and hopefully not ridiculously thick?) and apparently my cervical mucus on Friday looked 'great' (thanks Nurse Nelly, I think).

So, it just seemed like the stars were finally aligning for us. I got a bit of cramping and spotting from the procedure but all in all things were looking good. I even had the progesterone suppositories sitting on my bedside cabinet patiently waiting for Saturday evening.

And then Saturday morning came. I had some gluten-free toast for breakfast and ever so gradually all hell broke lose in my stomach. I have not had such abdominal pains since my worst IBS years. I was convinced that I'd eaten something glutenous or forbidden, but couldn't find any reason for this from my dietary choices. It had been a particularly stressful week at work with a number of aggressive incidents with clients, so I wondered whether my bowel was finally reacting to the stress..

My belly literally ballooned, but the pain was high up, like what felt like literally in my intestine. I was in agony most of the day. I felt shivery and weird and had mild temperature. Walking hurt, so I shuffled around doubled up.

I felt ridiculous. I'd had five follicles, there was no way that I could have been suffering from OHSS. And yet, what was this? A well timed stomach bug of some sort? Stress? My endo flaring up due to all the hormones that I'd pumped into my body?

My plan was to go to the walk-in clinic the following morning if things had not calmed down.

In the morning I had a bowel movement (sorry for TMI!!!) and afterwards I felt right as rain again. So I decided to wait it out. The symptoms returned but in milder form once I had eaten again.

I spent the day shuffling around again, sitting around and feeling sorry for myself (and watching things like Say Yes to the Dress) and am happy to report that by Monday (which thankfully was a Bank Holiday, i.e. non-work day - yay!) I was feeling much better and no longer had to walk around doubled up. I still had some level of pelvic discomfort (which has continued to this day) but nowhere near as bad as Saturday and Sunday.

I'm kind of kicking myself now that I didn't take myself to the walking clinic to get this checked out. Because now I'm just left with questions. I guess I was worried that they'd laugh me out of there and give me a diagnosis of 'strong wind' or something. So now I'll never know what's brought this on. Is this just the way I respond to having more than one or two eggs produced? If that's the case what's gonna happen during an IVF cycle when we're meant to maximise the egg count. Will I explode?!

I just feel like my pelvis is continually inflamed now and I can't see that being a great environment for an embryo to try to build their nest in.. Also I feel like I need to wee constantly (and this started before the progesterone). I think the closest to these sensations was the lap I had last year and this time no-one's been rummaging in my innards.

Is this normal after an injectable IUI cycle? I know some of you ladies have been diagnosed with mild OHSS so I would gladly compare notes.

Anyway, for now I am just dutifully shoving progesterone up my hoo-haa every night and hoping and praying for the best for this cycle.

Here's the thing - I thought I would get used to the needles. I really did.

But the truth is that I hate them; every single injection that I have to endure makes me want to vomit. I've always suffered from some level of needle phobia, but somehow managed to muddle through life, manning it up when it was time for the odd blood test or hep injection.

But this is different. I'm having to face my worst fear far more frequently than I'm comfortable with (and I've only just been through my first injectible IUI cycle; I can't even really make myself think of PIO shots and what not yet). And I genuinely thought I'd get used to them. I'd read so many blogs of amazing ladies who'd hated needles prior to treatments and after a couple weeks had become pros and started timing themselves etc to keep things interesting. I thought that one day I, too, would join this group of cool jab-confident ladies, but it doesn't seem likely anymore. I guess the good news is that it's highly unlikely that I'll ever become a heroin addict, such is my hatred of the sharps. Silver linings and all that..

Anyway. I hate the fact that I am having to go through this. I hate every needle, every side effect and discomfort, every medical procedure, blood test and speculum in my vagina.

I thought I could be a good sport about all this if I just kept my mind on the prize. But that just seems like such cold comfort, the possibility that this may work. Because right now I am putting myself through stuff that I truly, truly hate and all of this could lead up to a big fat nothing. And I feel like such a wuss and a failure even whining about this. I just feel like I want to give this up now, because I'm so sick of it and I've hardly even passed the start line. If this is how I feel during an indictable IUI cycle, how will I ever cope with IVF?

I really lift my hat to you ladies who've been through injectable IUI cycles and multiple IVFs - I don't know how you do it let alone with such panache and humour. Everyone else seems to be wearing their big girl pants but I seem to have somehow left mine at home.

I think I may be able to manage one more injectable IUI cycle and then the fresh IVF and a FET that NHS is offering free of charge, but I'm not sure whether I can manage any more than that. I mean obviously that will resolve all of our problems when it comes to deciding whether to go for private IVF treatments - if I can't hack anymore injections, then that's that I suppose. Our savings will be safe.

And yet I retain the right to change my mind. Perhaps it'll take a bit more than an injectable IUI cycle to get used to being injected regularly? Maybe it's a bit more of a gradual process? And it's not like I'm fighting some life threatening disease. I can decide to say no to this if it gets too much.. And like so many people have said before, if do get pregnant I'm sure all this 'suffering' will pale in comparison to the joy. It's just there's that big fat IF..

Thanks! 

So, having slagged off the NHS in my last post, I suppose I should admit that I actually had really quite a pleasant experience at the clinic today.

Perhaps I have earned enough NHS bonus points from our failed IUI cycles to now be treated with some kindness and courtesy. The thing is, once a cycle is started and I know what's going on, the clinic staff are actually okay.

Anyway, the RE, let's call her Dr Duchess (and no, she doesn't resemble Lewis Carroll's creation in the slightest but I am starting to run out of Alice in Wonderland characters at this stage so bear with me) was very sweet and talkative today.

I asked her about my thin lining during last cycle and she admitted that although Clomid is a friend of the ovaries it ain't no friend to the lining.

I also mentioned my pre-period spotting and ventured to wonder out loud whether there might be something the matter with my progesterone levels. And you know what, Dr Duchess offered to humour me by prescribing me some progesterone. Although apparently there is no scientific evidence to support its use, it won't do any harm either, so she was willing to give it a go. At this point she seems far keener now try whatever it takes to get me pregnant. Result!

The scan showed that I have three good size follicles (can't remember the sizes, but they were all around the 12 - 13mm mark) and my lining is looking plush (again I can't remember the figure - it may have been around 11mm, if that sounds plausible at all?).

And with the added progesterone, you never know, this one might just be a winner. (Check me out being all optimistic!)

So bring on the HCG shot and IUI - I'm ready to be hopeful again.

So, AF arrived on Monday. I dutifully rang Nurse Nelly; couldn't get hold of her so left a message expecting her to ring back and tell me when I was to go and see her again (for the first injection? a scan? some blood tests and maybe a cup of tea?).

She rang me back on Tuesday afternoon at work and told me she would book me a scan for Monday 18th, but that I should come in and pick up the needles before 5pm, since I would need to have the first injection that night or we mightn't be able to fit this cycle in before the Bank Holiday Monday when the clinic is shut (Whooaatt?!!).

How I manage to remain calm in these situations is still a little beyond me. So, despite the fact that M. had been to see her the week before (and had begged her to give him the needles) here she was now, asking me to come in and pick them up as a matter of urgency before 5pm or the cycle would be cancelled. I was finishing work at 5.30pm and the journey to the hospital is one hour at minimum - no chance.

So, cue in a panicky phone call to M. asking him whether he could get to the hospital by 5pm. He wasn't best pleased (understandably), but checked with his boss and was given permission to leave a little early. Situation saved.

But seriously, I am not sure how much more unimpressed I could get.

I don't think Nurse Nelly does this on purpose or out of meanness at all. She is just a little.. dozy.  She seems to live in her own little NHS bubble, and therefore forgets that patients 'may' have a life outside of the NHS, as well as other commitments that 'may' need to be taken into consideration.. The trouble is that her sweet demeanour and sort of bumbling personality means that no-one probably ever has the heart to have a go at her, so she just carries on bumbling along.. She is mostly harmless, but by golly does she at times send me reeling.

Anyway, I digress.

M. got the needles and the somewhat confusing injection instructions from Nelly (no videos, no DVDs, just verbal instructions. Welcome to the Easyjet of ART). By 11pm we were still unsure whether we were meant to be doing subcutaneous or intramuscular injections (i.e. into the belly fat or into the bottom muscle). As Nelly had many times repeated "just like the last time" referring to the HCG shot, we decided on the bum (I checked with N. the following day and she confirmed that this had been correct).

The first one was virtually pain-free. I think the nerves beforehand were far worse than the actual event. The following two (every second morning) haven't been quite so smooth, but still quite bearable. Vigorous rubbing of the injection site afterwards seems to quell the ache and the mild burning sensation.

I am still eternally grateful that M. has no needle phobia, so I can just lay on my belly and think of England while he mixes the junk and then does the actual stabbing. I am so, so very pleased.

Strangely, I think I prefer the injections to Clomid (I am on Menopur 150iu, which I believe, is the same stuff that is sometime used in IVF cycles, too(?), so I feel like it's sort of a step up and a good practice round as we slowly move towards IVF). I haven't really had many side effects; maybe some mild mood swings (e.g. a deep sense of poignancy, but no crying spells yet and a bout of rage relating to discarded bin bags at work, which I managed to nip in the bud). I have also been incredibly tired, but in a pleasant sort of sleepy way, which I don't mind at all.

So that's this cycle so far. It does feel a bit like some kind of a crazy hurdles race, where obstacles are constantly thrown our way and we need to somehow try to stumble over them towards the finishing line, which equally is continually being moved further away. But at least we're still in the race, eh?!

First scan on Monday and then presumably another one again on Wednesday and I would imagine that the actual 'procedure' will take place either Thurs or Fri. I think that has been one of the most frustrating parts of this whole ART experience- not knowing exactly when things will actually be happening and then having to rearrange things at work accordingly, and at times letting people down at a very short notice.

I am mildly excited, though. It's kind of nice knowing that medical science has taken over our reproductive lives again and that the pressure is off.

Now I just need to try to be assertive when I see the RE on Monday. I need to ask her how my lining is doing and if it's not doing well, what she is going to do about it. And whether I could, pretty please, have some progesterone to stop the pesky spotting this cycle around.

So upwards and onwards we go.

Warning: another long post. I seem to be suffering from verbal diarrhoea.

I have started spotting so AF should be here any moment now.

I have started getting really quite bad vaginal itching just before my period (so, so sorry for the TMI, but if I don't share it here, where will I - on a coffee break with my colleagues?) and this has happened a couple of months in a row. I was getting really quite concerned, until I googled it and found out that it is perfectly normal and due to the lowering of Oestrogen levels. Great, so another source of discomfort to add to the great injury that is AF each month! Gahh.

Before we went on holiday we'd had our doc's consult and a brief meeting with Nurse Nelly to discuss our next injectible IUI cycle. From that conversation I'd understood that it would be pretty much like the Clomid cycle except with added needles. I.e. ring Nelly on CD 1 to book a scan, start injecting on CD2, do so every other day and depending on the scan results stop injecting at some point.

So, dear M. went to pick up the meds from the hospital earlier this week, only to find out that needles weren't included when he got home. So I asked if he could go back after work the next day (he works much nearer and finishes normally by 4pm so can make it there in time, unlike me), get the needles from Nelly and just double check that we'd understood the instructions correctly. I even wrote down some questions (like whether we should inject morning or evening, and what to do if my period starts over the weekend) to ask Nelly so that M. could bring home the answers.

Well, M. came back without the needles and with this cryptic message from Nelly:  "a) Injections from CD 2 every other day, preferably morning (so far so clear),  b) if your period starts between now and Monday, call and leave a message saying that you'll be coming on Monday morning and I will inject you".

But, but, I thought we would be doing the injections ourselves..? And no one had told me about Monday morning before then, what if I'd arranged appointments with my clients or something!? (I hadn't but still, this sloppy and inconsistent communication is really starting to get to me - this was now Thursday evening). So I rang Nelly on Friday morning. Unsurprisingly couldn't get hold of her. So I just left a message saying I still felt confused about the cycle and asked her to ring my mobile or work numbers (thinking she would try one and then if she couldn't get hold of me would try the other) so we could talk it through. At 5.15pm I noticed that there was a message on my mobile phone (now this is where I have to take part of the blame myself. As it had been a really busy day I hadn't checked my phone regularly, thinking that Nelly would ring me on my work phone and had therefore missed her call). Basically she re-iterated that I should come in on Monday and I could ask my questions then.

I'm really quite livid and still in the dark as to how this will all pan out and how it will affect my work. What if my period doesn't start by Monday - do I still go and see her, or just ring her on CD1? I mean I could spot for days. My periods are pretty regular but I have the odd wonky cycle. Will I have to go there every morning for the injections, or does she just want to show me the first one (I really hope the latter)? Will the scans then be every other day or not; what does this all mean!!??

I just kind of feel like this is such routine to them (the staff at the clinic), that they don't even realise that us patients are completely left in the dark by their vagueness. Surely this is not good enough, even from the NHS!?!? I mean, will they be like this when it comes to the IVF cycle ("oh yes, just have a few injections and uhm.. a few scans and then we'll 'book you in'.."). I mean, I like to be well-organised and informed and prepared. And not only that I like being that way, but I have to, BECAUSE I HAVE A JOB!!! Aaaggghhh. I am sorry, but this just frustrates me so much.. And I am so envious of some of you, who receive such excellent care and actual time-lined plans etc. I am just scared that I am in the hands of some morons, and this is really pretty serious stuff here that I can't afford to be messed around with.

Anyway, having now analysed all the vague data Nelly has given me, I think this is what is supposed happen:
I will ring Nelly as near to CD1 as possible (even the weekend and leave a message if I need to). I will then go and have the first injection done by her (perhaps I'll also have a scan, perhaps they'll have to check for cysts etc - I'm just guessing here, because nobody's told me), she'll show me how to do it and then will give me the needles for the rest of the shots. I will go for scans every other day as I did with the Clomid cycle and stop injecting myself when they tell me. Then it's HCG trigger time and then the IUI. This would be the best case scenario and hopefully the more likely.

The worst case scenario - Nelly wants to do all the shots herself and I will have to go to the hospital nearly every day until the IUI (unlikely though, because surely that would be a complete waste of their resources.) So in order to keep myself sane, I will pretend that scenario one is true and be open to be told otherwise on Monday and completely change my plans.

I am starting to get a little worried though. Am I bringing this all on myself by not being assertive enough? Is this the way this clinic generally operates (I genuinely feel like I've slipped into some kind of Wonderland - who ever thought this blog's name would prove so apt)? Will added assertiveness make a difference or just put their backs up and make them treat me less favourably? What is a girl to do?!

I'm really hoping that when we get to the IVF it'll be done by some other people (even by the fierce head of the department - let's call her Dr Queen, who did my lap -  at least she seems competent, unlike the rest of her bumbling clinic staff).

Ooh, the joys of NHS.

Oh, oh and just one more thing since I've got started. How come I only learnt that my uterine lining was on the thin side during my last IUI afterwards and by accident through a letter that I received which had been sent to my GP (I have insisted that I am cc'd to all their correspondence, and thank God for that)? How come this was never mentioned to me during the cycle and how come nothing was done to actually thicken it!!?? These are the questions I will ask the RE (who is yet unnamed) when I next see her. I mean ggrraahh!!

Well, one thing's for sure. If I happen to get pregnant during any of these ART cycles, it certainly won't be thanks to the competence of the NHS but down to a pure, unadulterated miracle. So, maybe all this nonsense will prove to serve some purpose by strengthening my faith..

We came back from Finland last week; arriving back on Sunday and returning back to work on Monday. That was a bit of a mistake in that I've been so wiped out by work this week that even thinking about writing a blog post has been beyond my reach. So I can only apologise for my long absence, but if it's of any consolation, we had a brilliant time away. : )

I won't go into too much detail about the trip here, but the weather was gorgeous (+30 degrees almost everyday) and we spent as much of the time as humanly possible in the lakes (of which there are lots, and lots and lots).

We got to see my relatives, which was lovely. And you know the one thing about Finns that I really like, is that they don't ask too many personal questions. Despite the relatives fest (which included my Dad's 70th birthday party), no-one asked me once whether or when we are planning to have babies!! Either it's the culture (Finns are fairly private people) or the word has gone around (I've told my Dad and my step-Mum about our struggles and haven't asked them to keep it a secret, as it'll save us the trouble of telling everyone) and people are too polite to ask, but man, was that refreshing!

The only real heart-wrencher was finding out before the trip that two (out of my three close remaining friends in Finland) were pregnant; one with twins. I'd heard about the singleton pregnancy quite a few months ago on Facebook and sent my congratulations, but only heard about the twin pregnancy just before our trip.

I feel a bit bad about this, but I almost deliberately chose not to spend too much time with them this time around (they both also have very young children, which makes it trickier to attend activities, esp. when heavily pregnant). I invited them for a few things (a day at the beach, a day trip to Tallinn) but they declined from both, which I was kind of grateful for. We only really saw them at our God daughter's birthday party and even then for a short time only. By then I was able to put my own s*it aside and be genuinely happy for them, ask questions etc. So it was fine. Of course it hurts, but they're my friends and what are they supposed to do, put their lives on hold so that I can catch up? Hardly. So I'd put my big girl pants on and dealt with it (proud infertile moment*).

What really struck me (and was almost more painful than my two pregnant friends) at this party, was that we were the only childless couple left. And yet still, no one asked us about our baby making plans, not one! Oh, the polite Finns, how I love thee. But it was sad, really sad.. It just showed me how far behind we'd fallen in this whole 'creating a family' business. Some of the people there (who were literally only a couple of years older than me) had pre-teen kids! Ouch.

My only consolation was knowing that we will get there. It may take some time, but we will get there and one day we won't be the couple without kids, but just one of the many families. And then I'll be able to share my stories and experiences that I've had with my kids. And you know what, the truth of the matter is, that I didn't even mind listening to all the stories and shared advice about kids, I just absorbed it all and stored it up for later. Because one day, one day it'll come handy for us too!

Other than that our holiday was fantastic. Almost ruined by PMT (which quite frankly is getting out of hand these days and no amount of evening primrose oil seems to curb it), but again we dealt with it, got over ourselves and just had a lovely time together. It was actually really nice to be a bit removed from the IF scene. I deliberately didn't do any writing (I did follow all of you as best as I was able to and tried to comment, too - and hey, some of you got some really great news, congrats!!!) and it was just really nice, for a change. Which didn't mean that we didn't try this month, but somehow it just didn't seem all that important. (What's our chances naturally, anyway, eh?!)

It also cemented our determination to fulfil our dream of moving to Finland. M. has been in love with the country the moment he first landed there (which was 3 months after we'd met in summer 2008 - my cousin had a wedding there and I was planning to go so asked him to go with me. He met almost all of my HUGE family at that wedding and yet decided to stick around - impressive. And I remember my aunties commenting on how he seemed like a keeper ; ) . Language is a big issue and barrier for the move, but M is doing his best to learn it (poor thing, it really is an awful language to study as it doesn't resemble any other known language really) and we'll have to sort of start from the beginning again when we get there. But we've looked at the pros and cons and the pros seem to outweigh the cons, in that even if we'll end up being poorer there than we are here in the UK, our quality of life in so many ways would still be better. My Dad has an empty flat in south of Finland which we could hopefully use in the early stages as we set ourselves up (my brother has never shown any interest in it, despite having been offered it for his use). So once this infertility coaster has come to an end, that is our plan. We haven't told family and friends yet, as we don't want to raise their hopes, but are working towards it, as we do more research on the matter and slowly develop our plans.

I find that it really, really helps me, having an aspiration  for our future. It helps me to shift some focus off this infertility rally and provides me a glimpse of the bigger picture. This is just a season in our lives, it'll be over soon and after that there'll be better times ahead. Obviously this'll have some impact on our adoption plans (I have done my research obvs.), in that we'll have to let the Social Worker know from the start that this is our plan and it will limit our adoption options and probably increase the waiting time for a suitable child (if we go down that route). But, hey, since I've become an expert in the art of waiting, what's a couple of months / years, eh!?

This is turning into a bit of a gargantuan post so I think I'll stop here. I kind of feel like I'm a bit overloaded with things to say (perhaps taking a break from blogging wasn't such a clever idea after all) so I'm afraid you may just have to suffer the consequence in the form of back to back blogs, for a couple of days, so I do apologise in advance!

*) Courtesy of Awaiting Autumn - thanks for your blog post, it inspired me to recognise my own PI moment ; )