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Monthly Archives: August 2013

In a lot of ways, I am really glad I am going to have my theoretical baby in the UK. I like the midwife system, I like that there is less medical intervention on the whole, I’m pretty sure there are fewer c-sections and there is a marginally better infant mortality rate.

There are plenty of problems too…while the US medical establishment tends to push epidurals (there was a good anecdote in Expecting Better that I was talking about earlier – when she told her doctor she didn’t want to have an epidural, the doctor said, oh well you’ll probably have one anyway.)…the UK establishment tends to be against them. They are all about natural birth. You have to have a very strong voice (or your partner does) – in the middle of possibly one of the most vulnerable moments of your life – to get one, or else you have to be quite clearly unable to take the pain.

Personally I haven’t decided what I want yet and it will depend a lot on how various things go, but I would like the opportunity to decide freely, you know? Not pushed one way or the other. On the upside, I do have a loud voice and will make B have a loud voice too if necessary.

The NHS is also very pro breastfeeding. Now there is nothing wrong with that  – I am very much hoping I can breastfeed. But I think sometimes the pressure to do everything naturally (from giving birth to breastfeeding) can mean women for whom that doesn’t work out (ie their birth doesn’t go the way they wanted, there’s some reason they can’t breastfeed) they end up (or are made to) feel like a failure, when that is not the case.

Of course, all my opinions of this are based on TV shows, books, friends’ birth stories, and supposition.  Guess I’ll (hopefully) wait to find out what I really think.

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So I’ve mentioned how frustrating bad communication from the doctor or the clinic can be. There’s nothing like a rushed doctor who won’t listen to you, or getting a letter in the mail with a diagnosis and numbers but no context.

Which is why it was just SO nice to have a a doctor who took his time, answered all our questions, didn’t hurry us, and explained things in great detail. Maybe it was partly so good because we’d gone in with very low expectations, but he was really very good.

This appointment was about deciding whether we were doing IUI or IVF, and the clear decision was IUI. What he also made clear to us (for the first time in this whole process) is that we actually get 6 IUI tries and 3 IVF tries after that if the IUI doesn’t work. Which is really just fantastic.

AND, we might (though this was one point he wasn’t completely clear) be able to start earlier than December. Basically, three things need to happen before we can start now. (AND I WAS RIGHT, in your face first doctor, there is NOT a waiting list for IUI, it’s only for IVF. He really did not explain things well)

1. We have to have an appointment with a nurse to go through various things (we have a hunch it is going through the SAME things as we went through with this doc but oh well) and get the ovulation drugs

2. We have to buy the sperm and get it sent to our clinic

3. I have to get my next period.

That’s it. That’s all. We could start trying in September if everything moved at its quickest pace.

But the only problem is that we don’t have an appointment in the books with the nurse.  In the one instance of the reception being less helpful than the doctor, they were highly confused that the doctor wanted us to keep the IVF appointments we already had in November/December, but make a new, earlier appointment with the Nurse. So they took my phone number and said the nurse will call me.

“What do you think the timeline is on this?” I asked, meaning when will the appointment probably be.

“Oh, it should be within 3 weeks.”

“Oh, great!”

“Yeah, if she hasn’t given you a call in 3 weeks, call us up.”

So the timeline was that within 3 weeks we MIGHT get a call from the nurse. Snort.

I suppose it is still summer (though really, this weekend was a bit mixed), but thinking of these last few posts as a summer recap is making me happy. So there.

After the counselor, we did have a bit of a wait until I got my period. basically I had happened to be a few days into my period when we had the first doctor’s appointment, and it was too late to get the tubes test done that cycle. So we had to wait about a month and then call for an appointment, and then wait for the appointment.

But finally, we had the tubes test. They shoot some radioactive dye into your womb via your cervix, and push it up your tubes, and then x-ray you to make sure the dye got all the way up there, thus indicating your tubes are open.

It was the most painful 20 minutes of my life.

As I have mentioned before, I find pap smear/smear tests (depending on your side of the ocean) really, really, really painful. I have cried every time I’ve had one done, they don’t get better, and every time someone tells me to ‘just relax’ I want to punch them in the face. If I could fucking relax, I would fucking relax. And I just do not believe that the level of pain I have can just be caused by my lack of relaxation…

But I digress. I knew I find speculums (is that a plural word? I mean I’m down on speculum singular so I hope I don’t have to use the plural much more) painful, so I was already worried about the test – obviously if they’re sticking stuff up my cervix. they’re going to use a speculum.  B came with me for the appointment, which made me feel better, but then they wouldn’t let her come in the room with me because of the radiation, which made me feel worse. I did actually cry before I even got in the examination room (and YES, I know that means I probably wasn’t very RELAXED).

I was really scared – but realistically? I wasn’t scared enough. Smear tests take 20 seconds or so, if you have a good/motivated doctor or nurse, and let me tell you, having a panicking and sobbing patient often leads to highly motivated doctors. So the longest I’ve had a speculum in is maybe 30 seconds.

This was at least 5 minutes.

I was in so much pain, they almost stopped the test (to which I said, “is there any other way to do this?” “No.” “So I’d just have to come back and do it again?” “Yes” “THEN KEEP GOING!!!” I wasn’t going through that a second time ). I basically co-opted one of the nurses to just stand there and hold my hand – she actually had to designate someone else to do the job she was supposed to be doing. I was sobbing uncontrollably, and it felt – seriously, it really felt – like someone was pulling me apart from the inside out.

The actual tube test can be painful. It makes you feel like someone’s kicked you in the stomach with period pains, it’s very disconcerting and it does hurt. But that pain – it was NOTHING compared to the pain from the speculum. It was a candle next to the great fire of London.

When they finally finished (though I know they were trying to go as fast as they could), they lead me into a bathroom where B was waiting, and she helped me calm down and get dressed. The good news was they had found that my tubes were clear. yay. But boy did that hurt. And it hurt for days.  I couldn’t sit down properly for a week

I’m now even more terrified of the actual insemination process, and even less able to relax. Sigh.

I interrupt this regularly scheduled summer recap…

There’s been a recent controversy over this book:

Screen Shot 2013-08-27 at 8.23.47 AMhttp://www.amazon.co.uk/Expecting-Better-Conventional-Pregnancy-Wisdom/dp/1409142310/ref=sr_1_1?ie=UTF8&qid=1377589509&sr=8-1&keywords=expecting+better  (this is the british cover and link, where people are not reacting quite so crazily.)

Because in 12 pages out of 309, she talks about why a few of drinks of alcohol a week, no more than one a day, is not harmful, based on the evidence.

The whole book was about examining pregnancy rules, myths and worries in an evidence based fashion – an economist, she used statistical analysis and quantitative research skills to look at all the existing medical research on a variety of subjects. The point was, she was providing the facts so pregnant women could make their own choices.

Though from the amazon us comments thread, you would thinks she spent the whole 300 pages trying to convince women they should drink 10 beers a day while pregnant:

http://www.amazon.com/Expecting-Better-Conventional-Pregnancy-Wrong-/product-reviews/1594204756/ref=sr_1_1_cm_cr_acr_txt?ie=UTF8&showViewpoints=1

 

The whole controversy was at first crazy interesting and then hugely annoying to me. I picked up the book in my local bookstore as a whim, and had no idea it was in its first week of publication, let alone that it was the source of so much angst. Someone was suggesting women women make decisions about their own bodies! Woe betides us.

And then, just to make sure I was in a fighting mood, I read this:

Screen Shot 2013-08-27 at 8.34.25 AMhttp://www.amazon.co.uk/Intrusion-Ken-MacLeod/dp/1841499404/ref=sr_1_1?ie=UTF8&qid=1377588719&sr=8-1&keywords=intrusion

Which is an (AWESOME) distopian novel about a Britain not so far in the future, where pregnant women have to wear a monitor ring that reports if they have a sip of alcohol, where they can’t even work in offices where people smoked 70 years before, because of the minute, minute traces of carcinogens. As one of the characters handily puts it, ‘why take the risk, even if it’s miniscule’?

It was quite the coincidence that I read these both one after another, in the same weekend. Boy did they leave me feeling sensitive about the way that society feels it can make decisions for women, especially pregnant women, in their own best interests – rather than letting them have the facts and decide for themselves.

Over here in the UK, having a glass of wine occasionally while pregnant is not seen as a problem (though there are still debates). In america, it’s like a single granule of alcohol touching a pregnant woman’s lips is some sort of national crisis. And in one bit of Expecting Better, Oster recounts a doctor saying ‘well if we tell people they can have one glass, they’ll probably have more.’

And by people, that doctor means women. And by keeping the facts away from women for their ‘best interests’, it’s treating women like tiny children. And as Oster points out throughout the book, the vast majority of medicine around pregnancy does just that.

I’m not sure exactly what my point is here, except that basically, if I am so lucky as to get pregnant, I will be making my own decisions, even if I have to look up all the individual medical studies to make them.

As part of the process for having IUI or IVF with donor sperm, we are required to go see a counselor. I thought I would be kind of offended by that (why is it basically only the lesbians who need to see a counselor?) but actually, I ended up feeling that there were specific issues around donor sperm that were important to talk and think about before having a child. Like for example, how to explain it to him/her, and how to refer to the donor when speaking to your child (as ‘donor’ or as a ‘helpful stranger’ – not as the father, that is confusing, misleading and problematic for the idea of developing your own family. Not that we’d have referred to the donor that way anyway I don’t think – but still, good to know).

Also, the main thing I came away feeling was that EVERYONE going through this process, donor sperm or not, should have to see a counselor. We know straight couples who have gone through this and it’s been really hard on their relationship. One advantage we have as lesbians is that we’ve never tied sex to procreation, so there’s no sense of it being ‘pointless’ now, which is something I’ve heard from a straight friend when they realized they couldn’t conceive naturally. That sort of stuff would be really good to talk through with a trained third party!

The therapy session was really very good, relaxed, and positive, and the therapist stayed with us for an hour and 20 minutes, 30 minutes over the allotted time, just because we were having good discussions and she could because she didn’t have another appointment that day. Talk about a different approach to the last guy!

We did talk about our frustration with the lack of communication (among other things, in between these two appointments we’d received a letter about our treatment that listed my AMH count without any context. On the upside, it’s high. On the downside, it’s really really high. Trying to look up info about it online was a mix of no info and bad info, and we were left feeling nervous and uncertain about what it might mean. She obviously is not trained in the medical side and couldn’t interpret it for us, but it was good to talk about the lack of info and how that might be frustrating). We also looked at some picture books aimed at helping kids understand different kinds of families, and talked through our feelings on donor sperm (weird but necessary). She also gave us info on support groups and voluntary organizations, and other places where we could talk to other lesbians going through the same things.

Overall it was a really good experience, and we were left feeling much more positive about the overall process than we had been. And I was once again amazed at what the NHS provides – we (and anyone using the fertility clinic, not just the donor sperm-ies) can have as many appointments with the counselor as we want, at any point during the process. What a great resource! I wish that could be available for every single parent to be in the whole UK!

Over the last 2 months, I have been very busy. But do you know what I have not been very busy with? Getting pregnant.

We did have our first appointment at the end of june, which I mentioned in my last post (2 months ago! whoops!). Then I had a tube test (to check that my tubes were open), and then we had one more talking appointment. Oh, and we had a counseling session.  But It does feel like nothing is happening sometimes, which is part of why I haven’t been blogging…the other part is that I’m lazy but what can you do.

Ok! In order of appearance:

The First Appointment

Dun dun dun. This was the first time we actually got to talk to a fertility specialist, and…well…it was fairly anticlimactic. Of all the reasons I haven’t written over the last two months, my disappointment with this appointment was probably the biggest.

We each took a half day off work to go, because the appointment was in the middle of the day. We had all those questions written up, at least twenty. And we turned up 20 minutes early, just in case.

The waiting room in the fertility clinic at the hospital is quite different from most of the rest of my experience with the NHS. It’s quite bright in a non-fluorescent lights kind of way, airy and with quite nice receptionists, and even a water filter with cold water. We had to fill out another form, and once again I was really happy to see that they had a section for B to fill out that was for ‘partners’ that offered her a M or F  to circle.

When I went to hand in the forms I apologized to the receiptionist because I didn’t know the street number for our GP practice, only the street name.

“You should see what information I get from other people!” she said. “This is absolutely fine.”

When we got called in by the doctor, things got less…happy-making.

First, his accent was very difficult to understand. That wouldn’t be a problem if he was aware of it/trying to make sure we understood what he said, but he was most decidedly not.

Second, there was a nurse in their with them, and for the vast majority of the 30 minute appointment (I know how long it was because he kept telling us we only had 30 minutes and absolutely no more time than that, and implied that  if we didn’t get everything done we wouldn’t be able to move onto the next stage appointment) he talked to her rather than us. The only thing he addressed to me were questions. Do you have regular periods. How long is your cycle. You’re 30 correct? (all stuff I’d already put down on the form he was looking at)  Then he would make some unintelligible comment to the nurse. But mostly, he just wrote information into paperwork in his files. He barely looked at us the entire time.

He didn’t give us time to ask questions, and when we tried to force some in, he often didn’t really respond to them.  He gave us a date of December for when we could start trying to conceive  (this was June!) and when I asked if that was for IVF or IUI, he said it didn’t matter. This made me quite upset as I’d been under the impression that with IVF there would be a waiting list but with IUI it could start as soon as all tests were completed. He brushed off my follow up questions about this. And he said that the next appointment would be in november, to get the drugs for the december try. I’m sitting there, in June, thinking, seriously? They’re not going to see us until NOVEMBER! That was what really made me upset.

The one good thing about him was that we then did an internal scan of my ovaries, and he was very careful when I explained that I find smear tests really painful. In fact the internal scan didn’t hurt at all (though I was dripping jelly for about 24 hours). It did discover that I had polycystic ovaries, but he of course explained nothing about what that meant or how it might impact my chances of conceiving. He gave me a form for a tube test, said I should call them on the first day of my next period to schedule it. Then it was out the door.

Back to the very nice receptionist, who scheduled our appointments. She tried to help us as best she could and set up appointments for early november/december. But then she said when is your next appointment supposed to be? At which point the doctor popped back out of the consulting room and said we should have an appointment in the meantime and then popped away again, leaving the nice receptionist to find out when my next period was, and when then my tubes test would be, and set up an appointment at least 3 weeks later to give the results time to come in.

Bad, annoying doctor. not a great experience by any means.

 

Ok stay tuned for the next installment of the summer recap – Counseling.