Haisla's Adventures in Endoland

So, I decided to take a couple of days to reflect and gather my thoughts after our consult with the doctor before sharing them on the internets.

I'm aware that most of my recent posts have been of the more depressing kind, and although I have received such kind and compassionate responses, I am a little sick of always using this blog as the site where I discharge my darkest musings.

So I thought I'd take some stock and try to express here some of my more reasoned and balanced reflections for once.. (we'll see how I'll fare with that!)

Firstly, let me say that as a result of our consult, an IVF doesn't appear to be in the cards for us any time soon just yet.

For some reason I had misheard the doctor the last time we saw him and was under the impression that in our area NHS dishes out 3 IUIs and one fresh one frozen cycle of IVF to infertile couples.

Well, turns out that I was wrong and we are in fact entitled to 4 rounds of IUI (M. had thought this was the case, but had been wary to contradict my certainty). It also turns out that NHS is rather reluctant to skip any of the lower intensity procedures, so we are stuck with two more IUIs for now. With a month's wait in-between. Plus any extra-curricular postponements and delays that seem to be the NHS's forte.

The good news is that for the next two rounds we'll be using injectables rather than the blessed Clomid that nearly gave me double vision. The doctor seemed rather concerned about that. Apparently it has something to do with the hormones in Clomid triggering the pituitary gland, which can then have an affect on one's sight(?). The injectables on the other hand directly affect the ovaries, bypassing the pituitary glad completely. So that's one positive that came out from this consult.

So, note to self, if Clomid gives you eye-symptoms, ask for injectables instead!

When I asked about my age and whether IVF would not be better option for someone over 35; the doc's answer (I really need to come up with a name for him - let's call him Dr Caterpillar, in reference to good old Alice's Adventures) was that NHS will do IVF treatments up to the age of 40. I was so shocked at this answer that didn't know what to say in response! So, they would be quite happy to make me wait till I was forty before offering me IVF. No urgency, no recognition of my 'advanced maternal age', no appreciation of my rapidly diminishing ovarian reserve or decline in egg quality. Sometimes the NHS just makes me sick!

Then came a discussion of my weight again. I'd been quite pleased as I'd managed to maintain my weight steadily at the just over 20 BMI mark all year and had been quite self-congratulatory about it. Well turns out that that's not quite good enough and Dr Caterpillar considers me a poor responder based on our second round of Clomid (only one follicle). A poor responder?! But I ovulate every single month on my own!!! How am I a poor responder? (I didn't actually say this out loud - there is something about receiving these treatments free of charge that makes me bite my tongue, in case they decide to take it all away.. despite that fact that I have paid my tax an national insurance for the past 15 years in this country and am well entitled to the treatments I am receiving..)

Anyway, he recommended that I try to gain more weight. Apparently fat not only helps us to keep warm, but also regulates hormones, and so the more fat (within reason i.e. below BMI 30) the better the response to medicated cycles, it would appear.

Ironically since that appointment I have been suffering from the runs for three days now (apologies for TMI!), so have managed to lose even more of the precious weight  that I'd so carefully maintained.

I'm torn. On one hand I want to do everything in my power to make these cycles successful, on the other hand I am so sick of trying to eat more than is natural to me for the purpose of gaining weight. I had to do it last year for the lap and it left me feeling miserable and physically ill. I'll do what I can to make sure that I eat hearty meals and have snacks in-between, but I am not going to drive myself nuts over this.

So, the next steps forward look something like this:

Try naturally this coming cycle since we are flying to Finland for a two week holiday and I will be ovulating whilst there. (Nurse Nelly was thrilled when she heard that we are going on holiday and gave us a little encouraging smile that no doubt meant to say 'hopefully I won't be seeing you again'. I was almost expecting her to add the cheerful 'just relax' adage, but she knew better than throw herself to the wolves like that).

In August when we're back my period should start fairly shortly after that. I am to call Nurse Nelly again, pick up injectables and start jabbing myself at CD2.

If this round is unsuccessful, then we'll have a month's break (as stipulated by NHS to 'try naturally') in September and return back for IUI#4 in October.

With this timeline I am not expecting us to reach IVF until December, perhaps even Jan - Feb 2015, depending on the spanners that no doubt will be thrown in the works by whatever administrative errors, ultrasound closures, doctor's holidays etc that the NHS may care to conjure up. I am just trying to be realistic with my expectations here, having had my hopes dashed so many times.

So here are the positives:
1. We're doing injectables rather than Clomid
2. According to Nurse Nelly injectables are better for the uterine lining, which is excellent news, since with Clomid mine seemed to remain on the thinly side
3. We get 4 rounds of IUIs - I should surely view this as a positive; more is better than less, no?
4. We are still due two rounds of IVF - fresh and frozen - should all else fail
5. We aren't offered 6 rounds of IUI as is the case in some boroughs - can you imagine that!!! With all the 'rest cycles' that amounts to bloody 12 months all in all. And for some that is not a choice. It is a set of hoops randomly selected by NHS for people to jump through before they get to do IVF.

The negatives:
1. I'll have to wait at least 5 more months until we get to do IVF (i.e. we will remain on the "kiddie coaster" even longer than expected - thanks to JCH4DCU at Four Years Later for that lovely metaphor! : )
2. I will be a few months shy of 36 when that happens
3. My eggs are withering - why doesn't the NHS care!!!??

The questions I didn't have the tenacity to ask:
1. We've had two rounds of IUI - why didn't they work? 1 egg + 1 sperm + 1 reasonable uterus is all that is required and as far as we know we had all the components in place. WTF?!
2. I am getting older, and somewhere deep in my psyche IUIs seem like a big waste of time. I ovulate every month, M's sperm's okay, we have timed intercourse - what is the difference? What is the point?
3. What if I'm a poor responder to IVF meds and we don't get enough eggs to freeze? Do we forfeit our right to the FET?

Bottom line is that I feel peculiar after this consultation. I feel like the NHS is eking out these treatments in the vain hope that one of the cheaper ones will 'catch'. I don't think they really are able to see us as real people due to their restricted funding and guidelines. There is no real choice, we are on a conveyer belt and the choice is to accept what is on offer or walk away. And at the moment walking away would mean walking directly to a private clinic and parting with thousands upon thousands of pounds of money, which we can ill afford.

So the question is: do I stick with the free, no-choice treatments (with the risk that I may be wasting my time with sub-par clinicians, practices and facilities) or take our savings and choose to do probably max. one cycle of IVF at a top notch clinic and thereby exhaust all our options in one clear swoop (because the NHS would not take us back from going private). Since we are not rich, I am leaning towards option one. Am I being foolish?

Only four more days to go till our next consult.

Time has gone fast, I have to admit. I have been kept busy, which is a good thing, but  it has kept me away from the blogosphere, which I don't like.. Maybe it's done me some good..

It's been a pretty painful week, though, too.

We went to see one of my good friends I. and her husband H. and their wonderful nine month old baby girl E last Sunday.

I'd dreaded this visit, because as much as I love I, her husband and E, seeing them together always breaks my heart. I love spending time with them, but always, always end up leaving their place feeling wistful and blue. I just cannot help it. Because what they have is all I want. And surely that is not too much to ask? To have a family, a small but perfectly formed family, with all the difficulties and challenges that it brings. All the alterations to timetables and buying of baby gates and trying to find foods that the baby will eat, the crying spells and the sleep deprivation. And yet, I would welcome all of that with open arms.

And it's the one thing right now, that I cannot have.

I am so ready to be a Mummy.

And it wasn't always that way. It's taken me years, literally years, to get to this place where I can say that I am ready to be a mummy. Even when I met M. I wasn't sure whether I'd make a good mum or whether I liked children enough or whether I actually really wanted to be a mum at all or whether that was just yet another expectation that society had placed squarely on my shoulders.

Well, it turned out that the reason I wasn't sure whether I liked children was because I didn't really like myself very much. I didn't understand my own feelings or my own needs, so being faced with a small creature with desperate early needs and emotions just scared the s*it out of me. It all went back to my early childhood, my relationship with my dad; all very complex and painful stuff, but once I got it all (more or less) sorted out, I realised that I actually really like children. I am fascinated by them, I am able to enjoy their company, relish their innocence, take pleasure from seeing them grow and develop. I have patience and love to give. I am no longer perplexed and anxious, because I understand a few things about needs and emotions, now. Those little bundles that used to terrify me, now kind of make sense and I am drawn to them in a way I never thought possible.

So I'm ready to be a mummy, and it's not just an intellectual or emotional readiness. From somewhere I have acquired this deep yarning. It's not just a whim or an 'I want'. It's primal and raw and guttural and it rears its head when I'm around babies. It is like my body recognising what it is meant to be doing and responding to the cues with this deep longing. And yet somehow it simultaneously also fails to fulfil its function in turning that longing into a reality.

Another thing that makes me sad when visiting I. and her family is that she is my compatriot and is also married to a Brit. Our lives have had such parallel trajectories; we both came to the UK at the same time to volunteer in our early twenties (we met and became firm friends at our first conference) and were the only ones of that large volunteer group to remain in the UK to study. We've been through ups and downs; she went on studying further on, whilst I went on to establish my career, and we got married within two years of each other. We started trying to get pregnant roughly the same time (this was by no means planned!!); she got pregnant last year and gave birth in September. Her trajectory kept on going, whilst I got stuck on my tracks.

She has a child who is the perfect blend of her and her husband; she gets to speak our language to her child, introduce her to the children's books from our childhood and buy baby clothes from back home. That's what makes it so bitter sweet. In her I see what my life could be.

I may not get to have a baby who shares my heritage if we end up adopting. I may not get to breast-feed, or teach our child to speak my language from day one. I may not get to carry my baby and give birth. I may not get any of those things.

And that, my dear readers, breaks my heart today.

I sometimes write blog posts that are so depressing and self-pitying that they don't even really deserve to be released into the blogosphere (this is a sentiment often expressed by IF bloggers around cycle day 1, so I will join their choir today)..

This might be one of those posts, I fear; a post that perhaps should have been left for my eyes only.
So I can only apologise to you in advance and give you a strong prior-warning to enter at your own peril. For those of you joining here from ICLW, even deeper apologies for this fairly depressing introduction - I promise it is not always this bleak out on planet Endoland and that I will post a little recap of the journey so far and a better introduction in the coming days. Unfortunately this is what you'll be stuck with today:

AF has arrived again, and together with it, the crash and burn of a progesterone come-down.

As I have said before and will say again, I dread to think how I will fare when on synthetic progesterone. I can only imagine being a god-awful mess, if this is anything to go by.

And this is the problem of infertility blogging, especially for a girl like me, for whom, so it feels, nothing ever happens (IF-wise, that is). I'm just treading water, re-hashing the same old feelings, thoughts, responses, month after month. I can take the needed emotions out of the closet and line them neatly on the bed each month in anticipation of the arrival of the dreaded nemesis. It's become a well practiced routine, with only slight variations. I can pretend that it is not happening, I can play down the levels of hope. But every month, I lay out my emotions on the bed in wait for the arrival of the inevitable, in the hopes that being organised and ready will somehow lessen the pain.

It is monotonous and it is boring; it is even boring me writing this.

In many ways it's not actually like treading water at all, because at least with water you can imagine a beautiful beach or at least a pool where you can let go and just float to the top.

Not so, in this crap-fest.

If it's unlike treading water, then perhaps it is more like going around in ever decreasing circles, visiting the same sights with each passing month, with nothing new to experience or see or say, because it is pretty much just the same each time. I feel jaded and I don't know how many more circles I can go around, before I just go f*cking crazy.

I just want something to happen; something, ANYTHING. Give me a false positive, a chemical pregnancy, betas that are wonky, even a miscarriage (and please don't judge me for these thoughts, for of course I know that each and every one of those scenarios is a terrible tragedy and I would not wish them on my worst enemy), just anything that is not this nothingness, this absence, this blank where there ought to be a pink line, this blood in the panty liner, this bloating, this spirit-sapping, soul-destroying monthly little death. Because, yes, without wishing to sound melodramatic (which I obviously do), that's how it feels each month. A little bit of me dies inside. A little bit of hope, a little bit of that heady innocence, a little bit of the person that I used to be. It is being gnawed away by the greedy b*tch that is Infertility, and I have a feeling that she wants to leave nothing behind once she is done. How long I will allow her to gnaw away at me is anyone's guess. Because the other option is stopping, and that seems somehow even more unimaginable.

So I moan and I groan and I allow Infertility to gnaw away. It seems like a small price to pay when the ultimate prize is having your own biological child. But it does leave me wondering - who will I be when (if) the much expected finally happens? Because as well as being gnawed away, it feels like something else is growing back to replace the bits that were injured or lost. Something tougher and more leathery. Like emotional scar tissue.

And what if I don't get pregnant? Will the level of scarring I am allowing myself to go through be acceptable should I have nothing to show for it? Or will I forever regret that I allowed myself to become so greatly altered? Perhaps it'll pay to have a thicker skin?

So as well as moaning and groaning I try to insulate myself. With gratitude, with positivity, with prayer; by looking after myself mentally, physically, spiritually. But all the insulation in the world won't stop the gnawing from taking place, and I have to recognise that at the end of this process I will be forever changed. And that it is up to me to decide to what extent I will allow my emotional landscape to be ravaged.

I know that for myself I will have to let this carry on for a while still. Because I am not yet ready to stop.

This month I have decided to disregard any 'symptoms'.

You know how we were meant to have our next consultation at the fertility clinic on 19th June i.e. next Thursday?

You know how I had been looking forward to it so that we can finally have a new game plan?

Well, today I received a letter from dear old NHS stating that 'due to the reorganisation of the fertility clinic' (whatever the hell that means) they have cancelled our appointment and re-booked it for Thursday 10th July. WTF universe!!!!??? (Apologies for the excessive exclamation marks, but I kind of needed to use them to indicate the strength of feeling here).

I have had to adopt: "Breathe-'everything-happens-for-a-reason'- breathe-'everything-happens-for-a-reason'-breathe.." as my mantra just to stop me from absolutely hitting the roof. Not sure it's quite working..

This is typical NHS stuff and in some ways doesn't surprise me one bit. But it's shit all the same.

It adds another three weeks to my current wait (so not a TWW but a ThWW this time).

The ticking of my biological clock is getting deafening these days,  I haven't go the time for this kind of p*ssing-about!!

On top of that I had to cancel a session with my counselling client to accommodate the appointment on 19th.  And I don't like that. At all.

I feel like I should explain. As well as doing my day job, I see counselling clients once a week on a Thursday. (I'm proper qualified and all, but I know it's a bit shocking that they allow someone as emotionally doolally as me to see counselling clients, although I promise, all counsellors are a bit soft in the head and with their own little neuroses).

I normally try to bend over backwards to not cancel my counselling sessions as I know the disruption it can cause on the progress being made. It's just not fair on the clients, but sometimes I accept that it cannot be helped (like when I've got an infertility appointment to attend). So when the NHS starts messing me about, I'm really not happy. Basically I've cancelled next week's session and will have to cancel yet another session on 10th too, on top of two cancelled sessions in end of July  which coincide with my summer holiday. Leaves me feeling like a bit of a shit counsellor, really.

I guess I could try to contact the client to de-cancel (is that even a word?), but it does all get a little messy.. Grrraaahh.. I'll be on the phone to my supervisor on Monday, that's for sure..

The sad thing with the NHS is, that I daren't even try to bring this appointment forward. What would probably happen is that they'd cancel the appointment on 10th and then never get around to re-booking it. The above scenario is not unheard of with the NHS either. So 10th it'll be.

My last whinge is that I'd also already signed up for the IComLeavWe in the hopes of actually having something interesting (and infertility related) to say for people to comment on. Now it'll just be the same-old-same old 'twinge here, twinge there' stuff.

I think I may have to take up some exotic hobby (hang gliding or mountainboarding, anyone?) or something just to while away the days and to keep this space interesting..

I'm having to admit it, I am feeling deflated.

I was hoping to put it down to yesterday's bad weather, but today is sunny and I am still feeling the same.

I know it is probably partly progesterone related (I ovulated sometime around Weds or Thurs) and am now in the terribly depressing TWW territory again. I'm a bit concerned that I seem to be getting these depressive hormonal fluctuations more frequently now. It used to be just after my period (my post-period blues, that I could recognise and rationalise away) but now it also appears to happen post-ovulation.

I suppose it could also be the accumulated mileage of our fertility journey and the mounting disappointments. Or alternatively I take a really long time to process treatment related failures (i.e. our last IUI) and am just now mourning that, too. I don't know. I've always been a bit of an emotion burier and only years in therapy taught me how to dig around in my emotional quagmire to find the root causes for feeling blah at any one time.

So I think as a result of writing this post I've found it, the root cause for this bout of blah and it is the last failed IUI cycle, indeed. Thanks for dropping by sadness, it's nice to see you made it to the party after all..

But no, I should try to be a bit more compassionate with myself. It sucks. And yes, it was only our 2nd IUI and, yes I had very low expectations for it to actually work, but it sucks all the same. And I've got the right to feel angry and sad and deflated about it.

I think what really doesn't help is that I get extremely short and light periods with Clomid. Which lengthens the period of the lingering (almost psychotic) hopefulness that perhaps I may be one of those women who have light periods and then magically turn out to be pregnant after all. Well, I'm not. I ovulated last week, which I think finally nailed the coffin shut and proved to the eternally hopeful part of my brain that yes, the last cycle WAS A BUST. So now I can mourn and finally let it go. What a mind-f*ck, though, truly.

I'm sorry to be so angry and negative and deflated, but I promise you, this is actually helping.

I may now finally be able to get off my a*se and go and do something useful, like yoga or enjoy the sunshine or something. Thank you for anyone who is reading this for sticking with me on this messy journey. Hopefully I will be off to a sunnier disposition from here on end. Upwards and onwards as they say..

We have an appointment to see the consultant on 19th June!! Yay!

And I didn't even need to beg or pester.

I left one message. Rang the following day and was told that the appointment was already booked for us for 19th.

Should I be slightly concerned, though, that I still haven't received a letter to confirm this magical appointment? Perhaps I should re-commence pestering, just so that I'll have something in black and white. It's like the fricking Willy Wonka factory, this clinic of ours. The doors could easily shut on our faces, should we arrive without proof of our worthiness to meet the factory owner consultant.

So that's good news. Hopefully after 19th we'll have some semblance of a battle plan.

The bad news is that my next cycle is due to start two days before that appointment. Which means that my dream of getting an actual IVF cycle squeezed into this side of the summer holidays is probably not going to happen..  Timing-wise it's all a bit screwed up, but I'm trying to hold on to the hope that everything is happening for a reason and at the right time, etc. etc.

Now we just have another month to kill.. More 'natural' TTC (although I'm not sure how 'natural' it is to have a pre-planned sex schedule) on the menu then. Although I think we may just try to have fun this month. Somehow the hope of the (hopefully) upcoming IVF cycle is taking some of the pressure off. Which is nice.

And I think my gratitude exercises are helping. I am feeling genuinely happier just by counting my blessings each morning. Even if sometimes I'm just listing all the mod cons in our flat (this is when I'm still half asleep and unable to string a thought let alone list together).

So turns out that gratitude rocks. I'm going to try to keep it up, alongside yoga and healthy eating and enough sleep (not doing so well on that one considering it's nearing midnight and I need to wake up 6.30am tomorrow).. We'll see how long I'll manage to keep it all up.