Sunday, December 5

Health

I thought I would say some more about the nature of the whining mentioned in the previous post. I am very healthy. I have the same perfect blood pressure I've always had, very low cholesterol, excellent digestion, no illnesses or anatomical problems. But I'm in an extended phase (which I know is a familiar one to many people) of receiving extensive and fairly complex medical treatments, some of which themselves make you physically sick and all of which you get very very tired of, especially perhaps if you've had the luxury of robust good health for most of your life. It feels very stupid and spoilt to have anything complainy to say about all this because, first of all, it's entirely self-inflicted, and secondly because I'm very well aware that it's an immense privilege that I'm able to have this sort of treatment at all - my luck in being born now and not twenty years earlier, my luck at living in a country where universal health care makes it financially possible for most people to access excellent medical care, and everybody who is really ill. Nevertheless, with this good fortune there does come another set of different challenges to negotiate. 'First world problems' - sure. But problems just the same.

Our baby was conceived through IVF and this involved a cocktail of drugs and a regime of appointments and tinkering which I will try to write some more about properly one day soon, in part because I think it might be a good idea to keep a record for future reference of the medications I've received and partly because even while it was mainly pretty horrible to undergo there was a part of me found it all really interesting. The analogy that came to mind often was (don't laugh) the Apollo 11 moon landing - this immense technological achievement - and how that was achieved using what would in only a few years come to be seen as incredibly primitive tools. From my own very limited involvement with it I suspect fertility medicine is in a similar state.

It is now at a point where it can (sometimes) do something that for millennia was so far outside the realm of human possibility as to be the subject of myth. But it is achieving this by a sort of Heath Robinsonesque assemblage of ropes and pulleys. Yet the demand for what it offers is so urgent and the stakes are so high that we're steaming ahead regardless. Maybe - probably - the medicine will refine and streamline in coming years. But I suspect it will have a tough time keeping pace with pressures on fertility coming from elsewhere in the culture. It would be good if they could work on some of the techniques, though: I think the drug Crinone is an unjustifiably dangerous thing to give to women in the vulnerable state brought on by the latter phases of IVF and I'll be happy to hear when its use is discontinued.

All the same, I don't imagine that any improvements in fertility medicine will make much difference to the tendency it appears to foster in fertility specialists to view themselves as modern day Prometheuses set to outdo all the other arrogant doctors in the world. My fertility specialist, a very capable and intelligent woman who I hated deeply, was once in the middle of saying what she planned to do about something or other that my pituitary gland was doing without her permission when she actually said that she would change the treatment after she had 'made me pregnant'. She immediately corrected this to 'after you fall pregnant,' so clearly she knew it wasn't a view of her role in the proceedings that would be appreciated by her patient.

Anyway, after the IVF and some disappointment there I was of course delighted to at last have fallen pregnant with an embryo which seemed interested in sticking around for the long haul, and I thought the endless doctor visits would tail off for a while until we got nearer to the business end of things. But the doctor-visiting been pretty consistent and I accept now that it is going to stay that way. About a month ago my obstetrician diagnosed me with gestational diabetes. This affects about 8% of pregnant women - there is a genetic predisposition, but otherwise one has no control over whether one gets it or not - and is insulin resistance caused by a hormone generated by the placenta, so it tends usually to develop in about week 24 to 28 when the placenta is quite large and to peak around week 35, and to go away entirely once the placenta is gone. Glucose crosses the placenta so if I can't use the glucose I take in the baby cops it all, and grows too big and has health issues later. I am now nearly 19 weeks pregnant and so I have four to five months to go with the diabetes. Usually it is controllable with exercise and diet and I am able to keep my blood glucose levels under control this way when I'm awake. But I have not been able to reduce my pre-breakfast levels to an acceptable condition and so I've begun injecting myself with insulin - before bedtime for now, but it will eventually have to happen at every meal.

Because it's something normally dealt with by diet and exercise, you can imagine there is a significant amount of body-related guilt and failure-feeling associated with having to be treated with insulin, so early on especially. I would, however, be pissweak indeed if, with all my education and so forth, I allowed this to matter to me for very long.

And to be very, very, truthful, I don't think the FAIL part of it does matter to me very much now. Giving myself an injection is still one of my least favourite parts of my day, but when it pays off, as I know it will, and my blood glucose levels return to normal, I'll be happy about it. Nobody wants to have to give birth to a baby who requires a two-person lift. It would be nice not to have to go to the doctor twice a week, but this too shall pass.

24 comments:

Ampersand Duck said...

Oh dear, poor you. Self-administrated needles must be crap, because you can't think bad thoughts about the person giving you the needle. Still, I love the way you're rationalising all this. Isn't it marvellous, the love/hate relationship we have with contemporary medicine? Neither I or my boy would be alive without it.

Even if he needs a two-person lift, he's going to have an AMAZING mind.

Would love a letter, but all these blog posts are just as good :)
And yes, thanks to the modern marvel that is penicillin, I seem to be improving in leaps and bounds. QED.

Ampersand Duck said...

I cut & pasted then, and meant to say 'even if your boy needs...' but forgotted. Sorry.

lucy tartan said...

Penicillin is the bomb.

You can always think bad thoughts about the person who prescribed the injections, though, so that's fine.

M-H said...

Thanks for the interesting and informative post. My 12-yr-old granddaughter has type I diabetes so I've suddenly become really interested in all the manifestations of this metabolic disarrangement. The injections are horrible, no question.

librarygirl said...

Goodness me. You poor chicken.
My job share partner had gestational diabetes too, but it departed with the birth and the beautiful baby.
Do take care of yourself and be princessy and rest, won't you?

Tim said...

I don't really have anything to add, but I wanted to say that this is a really interesting post. Thanks.

Kerryn Goldsworthy said...

'Beware of Swoons, Dear Laura ... Run mad as often as you chuse, but do not faint.'

Stephanie Trigg said...

Great post. Sorry to hear about the diabetes. I'm on a course of monthly injections for five years, and was too much of a wimp to learn how to do it myself, and had to get the one I love to do it... He takes great pride in being careful, but it still hurts more than when the nurse does it. So you are brave, as well as a good mother, already!

Keri said...

Never commented here before, but I'm delurking to say thank you.

I'm going to be heading down the same fertility road myself shortly after the New Year, and it's comforting to see someone else describe the same feelings (gratitude, feeling that it's self-inflicted, and feeling it's very FWP)

That's it, really. Just, thank you.

Mindy said...

Gestational diabetes sucks. I hated the finger pricking the most. I hope you can enjoy the rest of the pregnancy and that the Drs visits tail off soon.

lucy tartan said...

Keri, please feel free to drop me a line any time you like, as it goes on. And good luck.

suze said...

Sorry about the GD but it's in a very good cause. I know so well the feelings around failure which I think are there for everyone who does IVF, even though in fact you have succeeded and that's the main thing.

seepi said...

IVF is a strange beast. It is like a secret world.

It used to be worse tho, before they thought of blood tests it was al done via urine tests,. and patients had to stay in hospital for the entire process. and then had a serious risk of triplets etc.

I guess those were the days pre moon landing!

genevieve said...

Congratulations to you both, and whine as much as you wish! you do it so elegantly it hardly registers as such.
Second KG's advice.

Bernice said...

Its curious the way meds respond to IVF pregnancies - they do have a bad habit of over-medicalising the whole shebang anyway, but the IVF thing turns them into Dr Frankensteins. As the proud owner of multiple IVF offspring, and knowing numerous more, they all seem mighty fine to me. Mighty fine.
Take care.

Another Outspoken Female said...

This too shall pass, indeed. Hope the nasty bits fly by over the next few months and you are left with all the exciting, new life bits to remember :)

R.H. said...

I tipped this.

But I'm shocked.


But congratulations.

Katrina said...

Laura, fantastic to see you blogging again, and brilliant to read about your pregnancy, despite the difficulties.
I have a couple of pregnancy/birth links I'd love to send to you if you like - entirely optional.

Max R said...

Marilyn and I are thrilled for you and Dorian, Laura, but sad about the injections.
The below is not relevant but its humour made me think of you... best from Max

http://www.commondreams.org/further/2010/12/08-4

Kate H said...

Mr Kate and I are currently going through the whole TTC thing (to borrow a term from those awful discussion boards filled with angel dust and baby counters and attendant shite) and even this so-far fairly short if stressful endeavour has left me feeling pretty antagonistic towards the whole medical industrial birthing complex.

So yes, I don't blame you for whining, and I don't think it is whining but rather a very understandable response to a stressful and trying period of your life.

Anyway, congratulations to you and D and I hope the GD thing doesn't get you too down.

lucy tartan said...

Thanks, everybody. Katrina, I'd love to have those links, please do send them to me - laurajcarroll at gmail dot com.

Bernice, Seepi, Suze, thanks especially. Dr Frankensteins is exactly right, B. Though I've got to admit, I've done some pretty strong projection onto the drs I dealt with, so it's impossible to say objectively whether they are really as arrogant as they appear to be.

I did notice that the ART/IVF specialists tended to be alone among doctors in being immune to the relaxing effects of learning that their patient is a university lecturer. Almost always this bit of info buys me a little bit less condescension - at least until they find out that I work in the English department, lol.

Kate, good luck dear.

meli said...

heh - my favourite moment from my previous pregnancy (which sadly went badly wrong) was when i was telling the receptionist at the ultrasound clinic in Adelaide my details and she asked: 'is it Mrs or Miss?' (a slightly more loaded question than usual), and I replied gleefully: 'it's Dr, actually.'

Which of course led to every single health professional I dealt with over the next few weeks checking whether or not I was a medical doctor at the beginning of each conversation...

Norway is very egalitarian and doesn't use titles, so dr doesn't do as much for me here...

Marshall Stacks said...

peace and love and good wishes from me.

Today the Google masthead is for Ms Austen's 265th.

kinds of cats said...

thanks especially. Dr Frankensteins is exactly right, B. Though I've got to admit, I've done some pretty strong projection onto the drs I dealt with, so it's impossible to say objectively whether they are really as arrogant as they appear to be.