The cost of a suspected ectopic pregnancy

You can’t put a price or a value on having both your fallopian tubes intact.  In fact I imagine that anyone who has lost one or two of their fallopian tubes wouldn’t be able to put a price on how much they are willing to pay to have them whole and functioning again.  Without a doubt.  And so when the doctor told me that there is a risk that I had an ectopic pregnancy and a fallopian tube could rupture at any point, you simply don’t think about the $$$ money.;

After I found out that my pregnancy was non-viable, the whole process of determining whether or not I had an ectopic pregnancy was absolutely soul destroying and mentally exhausting.  I tried to research what the likelihood was of having an ectopic pregnancy was with IVF.  I tracked my hCG levels to try and determine what my odds were.  I even joined several online groups to talk to other women who had experienced what I was going through.  (I have probably mentioned this before, I dislike online forums because you get exposed to some real stupid, dumb, insensitive and simply irritating people.  And you just can’t get rid of them.)  All of this led me to some tiny hope that I was going to be one of those women who was going to beat the odds and carry a pregnancy despite the slow doubling hCG levels.

The doctors cared a lot about my wellbeing and were concerned of an ectopic.  I mostly followed their recommendations:  We both dropped everything to come in to the clinic for blood tests, consults and ultrasounds.  What they didn’t tell us was how much it is all going to cost.  Like I said, when there is a risk of losing a body part or even worse, your life, the money doesn’t matter.  And now I can finally say how much it all cost.

I am not complaining about the cost because we are lucky, we have amazing insurance and we can afford to pay the bills.  What I would like to know is what about those people whose insurance wouldn’t cover the costs?  It’s just another slap in the face if you have saved up or taken on debt to pay for IVF.  Of course, most insurance companies cover the cost for maternity healthcare, but the treatment of an ectopic or any other type of pregnancy loss doesn’t come for free.  Remember I told you about the woman who couldn’t afford to have an ‘abortion’ to end her life threatening pregnancy at her hospital because of a CRAPPY law? (You can read about it here).

When you save up and take on debt for IVF, no one tells you to save a little bit extra in case things go slightly wrong.  I have discovered, however, that most hospitals and healthcare providers will negotiate the costs if you can’t afford this type of care.  There are also some charities out there that can help.  I also believe that friends and family will be there too to help out.  We have helped out some friends in the past when they got caught out with unexpected medical bills.  It’s not only a difficult emotionally, it can quite quickly become difficult financially.

So how much did it cost?  Luckily for us, not much.  The total cost was $3,107 of which our insurance covered most of it, and so cost us $140.   I have updated my ‘Cost Lowdown’ page with the breakdown of where the biggest costs lie here. But this has made me think about putting aside more savings specifically for unexpected healthcare costs.

My appreciation for the UK National Health Service has simply sky rocketed.

The dreaded HSG

I am not going to pretend to be brave here.  I am actually a little bit nervous about tomorrow’s HSG procedure.

The Hysterosalpingogram – AKA the HSG – is an x-ray procedure to check whether the fallopian tubes are open or blocked, and if the uterus is normal.  Iodine dye is inserted into the uterus to allow a contrast to be seen on the x-ray.  It allows the doctor to see on the free flow of the fallopian tubes and any abnormal lining of the uterus.  The procedure is relatively quick -about 5 minutes.  But for me it really was painful.  I took 800mg of Ibuprofen an hour before the procedure as instructed – it still hurt.

For my first test I was naive and had no clue it might be painful, so I wasn’t nervous.  But now, knowing what I know now!  I AM anxious!  The crappy thing is that Chris isn’t allowed in with me, there is nothing more I would like than for him to hold my hand whilst the dye is injected and I feel that burning cramping sensation run through my body.

When I called the clinic to make my appointment the receptionist who now recognises my voice (OK so I bet they don’t have that many Brits as patients) asked me why I hadn’t had an HSG already.  I pointed out I had one in January but I had to have another one after the possible ectopic pregnancy thing and how much I was dreading it.  She was very sweet and apologised, her tone also changed to be more somber for the rest of the call.  Bless, it was nice that she sounded to care. It must be a hard job working in a fertility clinic – it must be a bit bi-polar with so many highs and lows everyday.

Perhaps I will do some meditation to help me relax a little before hand :-s

On the positive side about this – once we have the results of this test we can go ahead and hopefully firm up plans for IVF round 2.

My HSG X-ray with my retroverted uterus (it's hard to see because it's hiding behind the catheter)

My HSG X-ray with my retroverted uterus (it’s hard to see because it’s hiding behind the catheter)

Abortion and the grey space

We hear this word used in everyday life – abortion. We can all formulate an idea of what abortion is….someone choosing to end the life of their baby. But this isn’t a wholly accurate or fair description and is certainly not what medical professionals use the word ‘abortion’ for.

According to Wikipedia, the term ‘abortion’ can be defined as:

“The ending of a pregnancy by removing a fetus or embryo from the womb before it can survive on its own.”

The unintentional expulsion of an embryo or fetus before the 24th week of gestation is called a ‘spontaneous abortion’. This is the clinical term that is used by medical practitioners in their notes to describe what most lay people would understand to be ‘miscarriage’.

The intentional expulsion of an embryo or fetus is called an induced abortion. Reasons for intentionally inducing abortion are either therapeutic or elective:

  • Therapeutic abortion is performed to save the life of the pregnant woman; prevent harm to the woman’s physical or mental health; where indications are that the child will have a significantly increased chance of premature morbidity or mortality or otherwise disabled.
  • Elective abortion is voluntary when it is performed at the request of the woman for non-medical reasons.

And then there are the methods of abortion, including medical abortion and surgical abortion:  Medical abortion (sometimes also called chemical abortion) is induced by drugs or pharmaceuticals.  Where as surgical abortion includes procedures such as vacuum aspiration, Dilation and Curettage (D&C), Dilation & Evacuation (D&E) and hysterotomy.

The use of methotrexate to terminate my pregnancy of unknown location or ‘ectopic’ pregnancy is described as a medical abortion and can also be described as therapeutic abortion. Clinically, I did not miscarry.  Although I am sure I had started the process of miscarrying before I took the methotrexate, and would consider it to be a spontaneous abortion – or – miscarriage – or – early pregnancy loss. However you want to ice it, in my medical notes it will be described using the word abortion.

For those who are not aware that this is actually a clinical term it can come as quite a shock to see those words on their medical records.  For example, here is a link to a news article: “Mom to be shocked when miscarriage called ‘abortion’ in medical records” that shows how easy it is mis-perceive the term abortion.

But definitions of abortion vary across and within countries as well as among different institutions. Language used to refer to abortion often also reflects societal and political opinions and not only scientific knowledge. Popular use of the word abortion implies a deliberate pregnancy termination, whereas a miscarriage is used to refer to spontaneous fetal loss when the fetus is not viable (i.e. not yet unable to survive independently outside the womb).

Paul Freeling and Linda Gask* explain the problem well:

“As children many of us learnt the old rhyme “Sticks and stones may break my bones but words can never hurt me”. As we grew older we discovered that the adage was untrue. For most of us whose profession involved interacting with other people it became obvious that clumsy or inapposite use of language could cause pain. An attempt to avoid such pain has provoked…to suggest that distress in women who have miscarried would be reduced if changes were made in the language used by professional carers…the word “abortion” should be avoided because the lay public interprets it as applying to a termination of pregnancy.”

And then there is the grey space in between all of this. This is where in the US definitions and clinical descriptions are all important for insurance companies.

I recently read about a lady who fell right in between this grey space….

At a 13 week scan several doctors told her that her baby had a heartbeat, but the organs were not inside its body, the hands and feet are curled, one limb was missing, the neck was not right. Overall, the baby was unlikely to survive and should be removed as soon as possible before it could cause serious health issues. By definition, in Ohio, this situation was considered by the insurance company as an optional abortion because there was still a heartbeat, therefore, they would not cover the cost of the $10000 operation at the hospital. Planned Parenthood would be able to perform the surgery at a cost of $800.

Eventually, after the doctors re-worded the case, the insurance company agreed to cover the costs. But it came at a cost. You should read the whole article to fully appreciate what this poor woman went through:

This blog post is not about pro-life or pro-choice. It is merely a brief peek into the complexities of the use and definition of the term ‘abortion’.

For me personally, the insurance company did not initially cover the cost of my methotrexate treatment because it was being used as an abortion drug. Eventually we managed to claim the cost back directly via our European insurance provider.

I don’t have a solution to propose, I just know that abortion – whether it is spontaneous, elective, optional, surgical, medical – is a confusing grey mess of an area in the US.

* Freeling, P. & Gask, L., Changing terminology is no substitute for good consultations skills BMJ 1998; 317 doi: (Published 17 October 1998)

NaBloPoMo November 2015

IVF round 2 – December/January 2016

We met for our follow-up appointment with our doctor yesterday.  There were no surprises.  Which is a good thing!  So the plan of attack is a fresh round of IVF…get a couple more embryos frozen:

  1. Schedule a Hysterosalpingogram (HSG – if you would like a refresher what this procedure entails, check out my post from last time here) – I will do this as soon as I start my period (who knows when that will be!!!).  It is very unlikely that my fallopian tubes will be blocked, but she wants to be sure.  Fair enough.  However, I am NOT looking forward to this test.  Last time I was completely naive to the potential pain ahead for this particular procedure, now that I know exactly how much it can hurt I’m a wee bit nervous!
  2. Plan to start Birth Control Pills to regulate my cycle in December with an egg retrieval date for early January 16.  There is a period of 3 weeks that the embryology lab is closed over the Christmas period.  Seriously – how unlucky am I?? Last time my cycle was delayed because the embryology lab was being refurbished.  Oh well – I guess everyone needs a holiday.

There is a potential chance we could start Birth Control Pills in November, and do a retrieval before Christmas, but I think it will be close to my 3 month period of ‘no baby making’ because of the methotrexate shot I had affecting fetus development.  I have been researching this, and I would be willing to go ahead a week or two earlier because doctors are overly cautious with this 3 month time stamp.  As long as I keep taking my folic acid I should have no problems.  However, this is something to be discussed once we have a better idea of a) when my period is likely to be and b) assuming my HSG test is all clear!!!

There will be no change to my protocol, perhaps a slight increase in some of the medication dosages to mature more of my eggs.  As a reminder from our first round we had 9 eggs retrieved, 6 of these eggs were mature, 4 of these eggs were successfully fertilised by ICSI, 2 good 8 cell embryos were transferred on day 3, and 1 of the 2 embryos made it to Day 5 blastocyst and was frozen.  Our doctor mentioned that she would consider waiting to Day 5 for the transfer this time around, especially as our frozen one is Day 5 – she wants them to be the same.  We like this plan!

This gives me some time to concentrate on work for a little while, get my body healthy and start growing some strong eggs!  What is amazing is what the horrrorscopes says for me next week…


I was already planning on going back on my sugar free, healthy diet next week! Freaky! Sooooo….which old friend should I Skype on Sunday next week and wants to reveal a long-held secret to me??!!!?!

My Mountains Monday Memoirs: Healing Holidays Days 1 to 9

This is actually a very recent memory!  But there there were lots of mountains in this holiday and we pretty much remained at altitude as we spent the majority of it on the Colarado Plateau. So here we go….!

This holiday was never meant to be a healing holiday.  We had been planning this road trip for almost a year, we even delayed it from May to October because of the infertility treatment.  But we decided to bite the bullet and book it for whatever stage we were at.  We were cautious and kept things less adventurous and a little more comfortable just in case I was anywhere up to 5 months pregnant.  We didn’t imagine that we would be leaving for this holiday with a cloud of sadness over our heads.  But yet despite the sadness, this holiday came at a great time.  It has been a chance to reset and refocus.  I know not everyone can afford to take the time off work or even have the money to travel afar, but I highly recommend getting away somewhere, switching the phones off and avoiding the rest of the world to help heal the mind.

This road trip was always planned to be epic.  And it sure was!  Here is a brief run down of our adventure:

Day 1: Excitement sets in (NV).  Finished work early (Friday)!  Fly to Las Vegas, arrived late and stayed at nearby airport hotel.  Teased by the sights and sounds of Vegas!!!  There are even slot machines in the airport baggage terminal.  Do people really get that addicted?

Day 2: Trippy & Valley of Fire State Park (AZ).  Picked up our rental campervan – AKA Trippy!  Can you guess why we called her Trippy??!

This was our 'cosy' home for the last two weeks - AKA Trippy.

This was our ‘cosy’ home for our holiday AKA Trippy.

We were upgraded from the small campervan we originally booked – woohoo! When I say upgrade – I mean we got an extra two feet of storage space!  Which we were grateful for.  Trippy had a table and chairs in the back that converted into a queen size bed and took up the whole width of the van.  Cosy.  In the boot (trunk), Trippy had a sink, mini refrigerator and gas burner.  All that was left to do was sign our lives away on a dotted line and Trippy was ours for 13 days.  We were off to our first stop – the Valley of Fire.  It truly was like the valley had been set on fire, the rock was a beautiful orange/red in the midst of a green flat plateau.

rt_valley of fire

Over looking the valley of fire

Day 3:  Zion National Park (UT).  Change of time zone.  Travelling five states in 2 weeks that are in different time zones soon became confusing!

We hiked up Angel’s Landing – a challenging climb if you were to have vertigo.

We hiked and scrambled to the top of Angel's landing

We hiked and scrambled to the top of Angel’s landing

Some people turned around as their fear got the better of them.  Chris and I on the other hand love this kind of hike/scramble.  It is easy to tell why this park was called Zion.

If you have vertigo this is not a great hike for you!

If you have vertigo this is not a great hike for you!

The view from the top of Angel's landing

The view from the top of Angel’s landing

Day 4: Bryce Canyon (UT).  The weather turned and the rain came in.  Our first disappointment came when we got the phone call from the horse riding tour company that they had to cancel the pony trek.  We were gutted because this is something on our bucket list!  It is also not a good idea to be in the lower rim of the canyon due to the high risk of flash floods, so we didn’t hike too far down into the canyon either.

Bryce canyon and the Hoo Doos

Bryce canyon and the Hoo Doos

According to the native Americans the ‘hoodoos’ formed when a tribe who did bad things were turned into stone by Coyote.  We don’t know the exact story because the story can only be told during winter time (according to tradition – the park upholds this out of respect for the tradition) – we will just have to go back some day in the winter to find out!  Despite the disappointments it was one of the most unique and spectacular places I have ever been to.

Day 5: Grand Canyon North Rim (AZ).  The rain followed us, and the clouds too.  Our first sneak peak of the Grand Canyon was somewhat disappointing.

A view of Angel's point on the North Rim - it was pretty cloudy. There was a whole canyon hiding behind this!

A view of Angel’s point on the North Rim – it was pretty cloudy. There was a whole canyon hiding behind this!

We were teased by little breaks in the clouds, but we could not get an impression of its greatness.  We waited for three hours at one of the view points for the clouds to break.  All of a sudden there was sunshine and we ran to the view point!  It wasn’t completely clear, but we could see a bit further down in to the canyon.

Chris got a great shot with the canyon in the clouds

Chris got a great shot with the canyon in the clouds

So we gave up and checked into the campsite.  This was when I got the phone call from my clinic telling me I should be having weekly blood tests.  I felt a bit emotional after this call because it was the first time in days that I had really thought about what the future 9 months wasn’t going to be.

As there was a bar at the Canyon lodge we decided to hike the 1.5 miles from the campsite to the bar just as the sun was setting.  As we reached the lodge, we were blessed with the most incredible sunset as the clouds dissipated!  It was truly magical – great things come to those who wait came into mind!

Finally! This is what the Grand Canyon looks like!

Finally! This is what the Grand Canyon looks like!

After our first alcoholic beverage of the holiday – and my first drink in months we hiked in the dark back to Trippy.  Chris took some wonderful starlight photos from across the canyon.   Just as we made it back it started to tip it down with rain.  What an incredible day – full of highs and lows in emotions.

Day 6.  Horse Shoe Bend & the Antelope Slot Canyons (AZ).  Wow.  The drive from the Grand Canyon to Page, Arizona, was spectacular!  Along the way we stopped at the Colorado River Horse Shoe Bend.  It was busy with tourists, but we were able to sit down for about 30 minutes whilst we waited for the shadows to move out for Chris’s photoshoot he wanted to get.  We sat and people watched.  So many people literally took a picture and headed back to their car.  It made me sad that this amazing feat of nature was not really taken in for all it’s incredible glory.  But hey.  We can’t all be nature lovers right?!

Horse Shoe Bend in all its glorious colours

Horse Shoe Bend in all its glorious colours

Following the incredible drive we arrived at Page where we had booked a Native American tour guide into the Antelope Canyons.  The canyon itself was impressive.  We were hearded through quickly like sheep.  Our tour guide was informative, but the crowds made me sick.  Apparently there are many other slot canyons like this in the Native American reservations but this was only one of two open to the public…and it is incredibly popular, apparently over the last year or so business has been booming because of the internet.  It’s great that so many people want to appreciate it, but I worry about the conservation of it.

Chris took some beautiful shots of the formations

Chris took some beautiful shots of the formations

it's a guitar....

it’s a guitar….

Day 7.  Four Corners and Monument Valley (AZ, UT, CO & NM).  We spent most of the day on the road, but managed to stop at the four corners monument…

One limb in each of the four states - CO, UT, NM & AZ

One limb in each of the four states – CO, UT, NM & AZ

…put all four limbs in each state all at the same time!   We also visited Monument Valley which is where a lot of wild west movies have been filmed.  It was truly an outstanding park.

Monument valley - everything image you had of a wild western was shaped by this landscape

Monument valley – everything image you had of a wild western was shaped by this landscape

Sadly there was not enough time to do a hike to one of the ‘monument rocks’ and we couldn’t drive.

Day 8.  Mesa Verde National Park (CO).  A.M.A.Z.I.N.G.  We managed to shake off the crowds, Mesa Verde was a lot quieter, there were no coach tours bugging me (I am completely selfish when it comes to enjoying nature – I want to enjoy it in peace and quiet without Japanese and Korean tourists shouting and selfy-ing everywhere I looked).  A lot of Mesa Verde had closed for the season, but we did get a tour round one of the more ‘adventurously located’ settlements of the cliff dwellers.  What struck me as really odd was that what we were looking at were rock dwellings that seemed to be from thousands of years ago.  But in reality, they were only 800 years old…it was amazing to compare the dwellings in Europe at that time and how different life was for the Puebloans (what I mean is how undeveloped they seemed compared to Europe).

Cliff Dwellings at Mesa Verde

Cliff Dwellings at Mesa Verde

Our tour around one cliff dwelling was a little 'adventurous' I was super impressed to see an 87 yr old lady climb this ladder successfully! Go Girl!

Our tour around one cliff dwelling was a little ‘adventurous’ I was super impressed to see an 87 yr old lady climb this ladder successfully! Go Girl!

We hung around the park to have dinner in our campervan and watched the sunset over the mountains.  Chris took some more amazing starlight pics.

Trippy under the star light at Mesa Verde

Trippy under the star light at Mesa Verde

Day 9.  Santa Fe (NM).  We weren’t really sure what there was to do in Santa Fe, we had a walking tour planned and knew we wanted to try some New Mexico cuisine.  We were surprised at the incredible art galleries here.  We also saw America’s ‘oldest church and building’ (considering we had just come from mesa Verde I am not sure they could claim the oldest building title).  I chose a mexican restaurant and was excited to be eating Mexican food that was actually spicy!  Where we live in Virginia the Mexican food has little spice to it and is covered in cheese – more Tex-Mex than Mexican.  So it was a real treat, and poor Chris ate it despite his ‘sweating’ from the spice.

America's oldest Bell in the Oldest Church - with whole bunch of Milagros (representing miracles) pinned into the wood

America’s oldest Bell in the Oldest Church – with whole bunch of Milagros (representing miracles) pinned into the wood

How lucky are we? Just 9 days in and it was already epic!   Days 10-16 to come next  week!

Mountain Lesson #8: Enjoy the journey.  Sure the infertility journey can be a long one, but sometimes you need to take a little diversionary break to feel the power of mother nature and help lift your mood to higher states of happiness.  Take a breath, take a rest, soak up the sun – let the beauty of the mountains reset you.


A discovery – How far are we willing to go?

Whilst on our epic South West USA road trip, Chris and I had lots of time to talk to each other.  You could almost say we lived in each others pockets for two weeks…some couples might break…but for Chris and I we kind of thrive on it, and it brings us closer together.  I think we only had one small ‘argument’ on this trip, but you could probably describe it as more of a strongly heated debate rather than an argument as such.  Anyway, the point is, we had lots of time to talk about some of the bigger things in life.  Surprisingly, we didn’t talk about our future as prospective parents for several days.  It wasn’t until I received a phone call from our fertility clinic that we got around to talking about it again.

The topic of conversation was how much more can we deal with all the infertility treatment?  Can we deal with another miscarriage or ectopic pregnancy?  The likelihood for another ectopic pregnancy almost doubles after you have had one.  What about dealing with a negative result?  We discussed whether to transfer our one frozen blastocyst or to go for another round of IVF/ICSI.  Yes, a frozen transfer would require injections, but I would avoid the egg stimulation and egg retrieval process which, for me, was very painful the last time around.  Chris wants to avoid me being in pain as much as possible.  He hates seeing me in that way.

I understand his point of view, it is hard for a partner to see their loved ones in pain over which they have no control.  But I feel differently, I feel like I know what to expect, how to better deal with the symptoms and feel overall less anxious (although I think I was pretty cool in my attitude about the first IVF cycle).  I feel ready to get some embryos frozen into reserve.

I am 32 about to turn 33.  If we go for the frozen transfer and we succeed in a pregnancy (!!!!! That would be awesome!!!) then I will be 35 by the time we are ready to have a second go at it for child #2 – my egg quality is likely to reduce and we could be facing an additional factor to our unexplained infertility.  So I figure it is best to do one more IVF/ICSI cycle now and we have one in reserve.  Perhaps I sound a little greedy in this respect – we are lucky to have one frozen right now!  I don’t mean to be – but I am an operational analyst after all, so I can’t but help try to figure out the optimal solution to a problem.

I explained to Chris my reasoning for going ahead with another round, and he gets it.  He admitted he hadn’t thought about age related factors for the future.  So we have both agreed that tomorrow we will ask our doctor about going ahead with a new round of IVF/ICSI.

But this isn’t really where the story ends.  I think Chris and I have different ‘lines’ to draw under how far we are generally willing to go to get our own baby in our arms.  How many times is enough to say we gave it our best shot?  How many times can we deal with sadness?  Will we ever become numb to it?  Depending on the nature of the outcome for round 2 will create different visionary paths in our heads for each of us, we discovered that they are not aligned at the moment.

This isn’t an easy topic to talk about without accidentally hurting each other with words that first come to mind…. so we are going to try writing down our feelings on paper and swapping our ideas so that we can understand each other’s perspectives.  I don’t know whether it will work, I hope it will help us at least gain a respect for each other’s feelings.  Love and marriage is unconditional, but feelings can easily get hurt when we are talking about something so passionate as becoming parents and how to do it.  Infertility knocks you for six when you discover that you can’t become a parent the ‘normal’ way.  So I think it is healthy to have this exploration of feelings and keep things open between each other.

Perhaps we will share these letters to each other on the blog at a later date, but for now we just need to focus on getting to the same place together.

6 weeks post methotrexate treatment

It’s been 6 weeks since I was treated with methotrexate to terminate my ‘ectopic’ pregnancy.  The first few weeks involved dealing with miscarriage bleeding and pain.  Pains that made me worry about ending up with a burst fallopian tube.  Pains that I had never experienced before.  Then there was the emotional pain that accompanied it;  sadness and grief over the failure of what could have been.  Finally, at what would have been my 13th week of pregnancy my hCG levels are below 5 and I am officially out of any danger.

Progression of my hCG levels over time

Progression of my hCG levels over time

But although I am grateful I have had zero complications (i.e. no tube ruptures or not needing a D&C) it hasn’t been the easiest of rides.

4 weeks ago I fell ill with what seemed to be the usual cold/cough that one catches in September time.    Methotrexate can lower the number of white blood cells, which increases the chance of getting an infection and being able to fight it off effectively.  I haven’t been able to shake off this cough completely and it got worse over the last four days of my work travels to Germany.  I think my cough has gotten worse because my stress levels increased due to the nervousness of the upcoming conference, and my poor sleep due to flying/time zone changes.  Basically, I haven’t been good to my body.  I had to avoid my multi-vitamins until my hCG levels were below 5 because the Folic acid in them can interfere with the effectiveness of methotrexate.  So I have been dosing up on Vit C, but I have been missing out on all the other immune boosting vitamins and minerals.

The morning of the beginning of the conference and the day I was presenting was when I felt my worst.  I had to run out of the conference during the key note speech because I was about to puke up my guts from all the coughing.  I wasn’t sure I was going to be able to close the day with my presentation….which I was already stressing about because it was in front of my about 100 of my peers and various other important people I need to make an impression with. Fortunately, I managed to survive  and my presentation went down well – I had lots of excellent feedback.  But the stress of it all was just making my cough worse.

On the evening before my flight back to the US I took some nytol/night nurse at 8pm and was immediately fast asleep.  I woke up at 1005 AM and realised I had slept through my alarm.  I was supposed to already be at the airport by now, my flight was leaving at 1215 PM!  I had been in a deep sleep for 14 hours! Aghhhh!!!! Panic!!!! It is not like me to sleep for long, I am not the kind of person who likes to lie in.  So there I was hacking my guts up and had a temperature running.  But I needed to get home!  So I threw everything into my suitcase – higgledy piggledy- checked out of the hotel and ran to the train station.  1 hr after waking up and freaking out I was standing at the airport check-in desk with 10 minutes to close!  I made it, but I was lucky to catch the train that I did, 3 minutes later I would still be in Germany right now!

I felt awful for the poor German teenage girl sat next to me on the flight (it was a completely full flight) because I was coughing every other minute the entire way.  Cough medicine, flu medicine, cough sweets, water – everything I tried, just could not stop me.  I felt like I had done 1000 sit ups!  My abdomen was aching and my throat shredded.

So here I am, finally tucked up in bed, at home, with magazines (thank you Chris :-)) and hot tea, relaxing.  I may be my worst enemy when it comes to being ill, but I will say that I totally blame the methotrexate.  My white blood cell count was already below the normal level before I took the shot – so I can imagine it was severely lowered afterwards.  I could have wrapped myself up in a cotton wool ball – but I would have been bored as hell and probably missed out on our epic holiday.  So, yes, I kind of did this to myself…but today I am FINALLY chilling out.

(Who wants to bet I have caught something else from the last few days to add on top of my cough?)

I am excited about next week though because the only meeting I have in my diary is our doctors follow up appointment.  Being out of office for three weeks does have its advantages!  Fingers crossed I wake up tomorrow feeling better and I can start everything -work, life, infertility – all afresh 🙂

Who is Dib Dab?

On my last day in the office before our road trip a friend and colleague gave me a small gift and note.  The gift was a small stuffed toy cat with two different coloured eyes.  I am not an expert in kids toys and I have seen these cats around and but I still have no clue behind their story!  But anyway, this gesture was incredibly sweet and I welled up with tears at that very moment.

This isn’t the first gift we have received since receiving the sad news of our non-viable pregnancy….

One friend sent me a guardian angel – Angela, to put in my purse…she has been with me ever since and holds a special place with me.

We received an anonymous ‘donation’ of twelve big Cadbury’s chocolate bars (finally discovered it was from my parents!).  We have scoffed a total of three bars between us so far.  I have hidden all but one of them from Chris when I left for Germany to make sure there was some when I got back!

We also received a wonderful box of chocolate biscuits (cookies) from two friends shipped fresh all the way from the UK that spelled out ‘We love you’…they were incredibly crumbly and delicious, they didn’t last long!

A friend and colleague of Chris’s scoured the internet to surprise me with 6 Cadbury’s (UK) Crunchie bars after I had posted on facebook my cravings for one and my inability to find them in our local vicinity!

A lovely blogging friend sent me some haribo (my favourite sweets in the world!), digestive biscuits and a figurine of hope.  Hope is something I need reminding of a lot and was just what I needed particularly at that very moment in time.

We also received countless cards, letters, messages and hugs from friends and family across the world.

We were not alone in our sadness, friends and family went out of their way to show us they were with us.  It has been incredible.

So what has this all got to do with a stuffed toy cat?  Well I took that stuffed toy cat with us on our road trip, and we named him Dib Dab.  Dib Dab came with us everywhere we went…up a mountain, through the desert, amongst the hoo doos, in the camper van, in the museums & restaurants – everywhere.

Dib Dab was just a small representation of our friends and family at this time of healing.

Thank you for your kindness, love and thank you for just being there.

Dib Dab ended up having quite a bit of fun 🙂 Mesa Verde

…at Mesa Verde the puebloan ruins

…at the puebloan ruins antelope canyon

…at antelope canyon Bryce canyon

…at Bryce canyon Zion National Park

…at Zion National Park


…In Santa Fe the petroglyph national park

…at the petroglyph national park

...on a petrified log

…on a petrified log the Petrified Forest

…in the Petrified Forest my back pack

…in my back pack

...on the Grand Canyon Train

…on the Grand Canyon Train

A small reminder that I have absolutely no control over this

It has been 6 days since I have thought deeply about our recent loss, but today I have thought about it a lot.  The past six days have been truly wonderful (we are currently on a 15 day road trip in the South West of USA); Chris and I have hardly talked about what the future holds for us as prospective parents trying to conceive.  No baby talk.  No IVF talk.  Who knew we had so much other stuff to talk about!

All was well and good in the mind of Dani, until I received a phone call when I was at the top of the North Rim of the Grand Canyon, from my clinic, reminding me that I am supposed to be taking weekly beta blood tests until my hCG levels are below 5.  I was a little peeved about this call.  I was annoyed because the day after my last blood test (Monday 27th Sep about 12 days ago) no one called with my  test results, I waited until the day after, still no call.  I had every good intention to call them to check what my results were, but my week got so busy at work that I never made the call, and they never called me.  So, on Friday 2nd Oct, I flew out West, in holiday mode, thinking that I must be in the clear, otherwise the clinic would be harassing me on the phone by that point – and so I thought nothing more of it.  Until that moment in the Grand Canyon.  Now in their defence, they could have called me at any point on my holiday and I wouldn’t have received a message from them due to lack of connectivity to the ‘real world’.  Never-the-less I was still slightly annoyed.  I told the nurse that it would be a bit tricky for me to come in the next day for a beta blood test because I was currently in Arizona and wasn’t planning to be back until next week.  So I asked her if my beta level had dropped sufficiently that it wasn’t urgent for me to take a test.  She told me levels were at 49 (finally, I found out my result, until that point I had no clue).  She said she would message the doctor who was overseeing my methotrexate treatment, to let him know I was away.  She thought it wouldn’t be a problem.  I have heard nothing more from the clinic – so I assume all is good with the world, they are not seriously worried….but again….my access to signal is poor to terrible, so who knows?!

Receiving this call briefly reminded me where I was just over a week ago and I felt a bit sad again.  But that was a brief moment….and the holiday fun continued.

That was, until yesterday.

I woke up yesterday with period pains.  I thought uh oh, I’m not really prepared for my period to happen just yet!  BUT my period showed itself within an hour of me thinking, hmmm my period feels like it is coming.  That in itself is unusual, I normally get a few days advance warning of pains and twinges.  I have previously read online that a period following a miscarriage can be painful and heavier than normal (I don’t really know what normal is supposed to be anyway!!!).

Initially, I was excited because this meant that I would have one normal cycle, then the next cycle have the dreaded HSG test (again :-S), then the third cycle start the Birth Control Pills for next IVF cycle, all before Christmas! Then when I actually thought about it and counted the number of days since I stopped spotting from the miscarriage – it was 16 days since the heavier spotting, and only 13 days since zero blood.  So the question I had on my mind was – is this actually my period? – or am I still miscarrying?  Everywhere I have read, they say 20 days from end of spotting or hCG below 5, minimum.

And then…..last night I woke up from sharp pains, although they dissipated quickly, just a few hours later, I passed a clot the size of half my hand, I have never experienced this with any period before.  But like I said, I have no clue what is normal.  And because I have missed my beta test this week, I don’t really know if my hCG levels are back down to 0, so I cannot say for sure this is my period.  All day today has been very heavy and very clotty, I felt like I was miscarrying all over again.

I feel sad, all over again.  The hormones probably have a part to play, but the sadness has washed over me.  Just as I was on my way up.

I’m simply tired of being sad for us.

I have missed blogging over the last week, I have missed reading all the other lovely blogs, I need to hear the good news stories, I need to hear inspiration; I feel like I’ve missed out on some therapy of the mind and soul.  Despite my respite from the rest of the world and the wonderful distractions from Mother Nature.  But I am writing this today as we drive to Santa Fe – I just couldn’t wait.  Chris is probably cursing me right now as we head into Santa Fe getting lost because, as the chief navigator, I am distracted with writing my thoughts.

Please, please let this be an exceptionally heavy period and not a continuation of the miscarriage.

Infertility is teaching me that I have absolutely no control over any of this – my body, my mind. And so although I tell myself it is pointless trying to wish things to be right, I just can’t sweep the sadness aside for today.  Hopefully tomorrow will be another day, another day on the path to slow healing.

The healing power of Stockholm and my Nobel Prize

As I return from my work travels in Stockholm, I have some down time to reflect upon our recent failed first round of IVF.  I say ‘failed’…it’s actually quite difficult to say with any confidence that it was actually the IVF that failed us.  It is possible I suffered an ectopic pregnancy, but the doctors were unable to confirm it, although they treated me for it with methotrexate to terminate the pregnancy to be on the safe side.  Something was growing, they just could see it.  If my pregnancy was truly ectopic, then it wasn’t the IVF that caused the demise of my pregnancy….the IVF treatment managed to get me pregnant, but my body decided it wasn’t going to succeed; my body simply decided that this wasn’t my time to join the pudding club.

Or it could all simply be described as just terrible bad luck.  Sometimes, there is just no reason known to man why Mother Nature can be so cruel.

Of course, it is natural to blame oneself.  There are several potential causal links to an increased risk of ectopic pregnancy: tubal damage, smoking, age, IVF – all of these increase the risk: approximately 1-2% of pregnancies are ectopic.  But mostly there is just the plain and simple element of unfortunate luck.  You can find on the web doctors who speculate that the risks are higher with IVF because either:

  • a) With a 3-day transfer, the embryo that would ordinarily be in Fallopian tube at this stage, seeks out the more fluffy warm tubes because that is where it thinks it should be, then gets completely lost and doesn’t ask for directions.
  • Or b) the doctor who performs the embryo transfer procedure places the embryos too high up in the uterus; or they are transferred too quickly and end up in the wrong place.

However, my doctor explained to me that statistically speaking, the risk of ectopic pregnancy doubles with IVF because generally there are two embryos being transferred and so that risk doubles from 1% to 2%.    This makes a whole lot of sense to me.  I was just unlucky.

I am thinking through all of this right now because I need to take away something positive from this failed cycle.  I’ve got to get my cup half full again….and so the positive could be that we just needed that extra help from ICSI or the hormones, and I was just one of the really unlucky ones to not stay pregnant this time.  Next time might just be our time.  There is still no reason why it shouldn’t be.

I was feeling a little sorry for myself in my last post.  But the last couple of days have been an improvement, and it is starting to look like our path is finally beginning to flatten out, allowing us to take a breather.

Time to catch a breather before heading off on to the foggy path called infertility.

Time to catch a breather before heading off on to the foggy path called infertility.

I have been kept mentally busy with work, socialising and networking with my colleagues, so I have had little time to think emotionally about the failed round of treatment.  Physically, the pain has dissipated, the bleeding continues (seriously, where does it all come from?!!?), but it is a very small amount that it has barely bothered me.  I still feel exhausted, but jet lag most likely lays claim to the cause of that.  I miss my pre-natal multi-vitamins, I really hope to be allowed to take them again soon.  They help keep my bowels in shape and my energy up.

And I will grow back my positivity because over the next 3 months as we have a plan to get us to our next IVF cycle (hopefully if I get the all clear from my repeat HSG!!).  In short – we have our 2 week, 2000 miles, road trip starting from Las Vegas, visiting various amazing places like Grand Canyon, Zion national park, Bryce Canyon, Monument Valley, Santa Fe, Albuquerque, Petrified Forest, Painted Desert, Hoover Dam and a whole lot more.  I have another 3 work trips to Europe to fit in – Munich, Berlin and Brussels/Mons (I haven’t been to Berlin yet so that is exciting!).  We have a consult with our doctor scheduled for late October to discuss the plan for the next cycle.  I need to find some time to fit in a HSG once my period returns (seriously NOT looking forward to that).  I am hoping my body is going to play nice and we can get an IVF cycle in just before Christmas.  It’s also Chris’s Birthday soon and I want to organise a small party for him.  And amongst all that we are going to try and fit in a weekend away to Shenandoah National Park to see the beautiful colours of autumn.  No time for stopping over the next 3 months!!

Stockholm has done me a lot of good (despite the jet lag), I’m feeling mentally refreshed and excited to be moving forward.  However, I was very disappointed to discover that my invitation to pick up my Nobel Prize must have got lost in the post.

No Nobel Prize for me.....But it was beautiful!

No Nobel Prize for me…..But it was beautiful!

But I did get a chance to scope out the building they award them in, the museum my name would be listed in, and the best restaurants to celebrate at….May be someday I’ll be back 😉 bahahahahaha – Keep dreaming Dani!

The Nobel Museum, Stockholm

The Nobel Museum, Stockholm – Something to reach high for 🙂