Today they say ovulation disorders, and in particular ovulation induction, is linked to lower breast cancer risk.

And they say there are promising techniques under development for women who have had OHSS and have subsequently failed to fall pregnant.

I'm a young infertile. That is, youngish. I'm not as young as I used to be, and I'm not as young as some. I have crows' feet, it's true. But unless I'm terribly unlucky, I still have a good decade left in my reproductive organs. So - young.

Want to know what I'd do if you walked up and told me to be thankful for that?

Well, I'd grit my teeth, and I'd smile a brittle little smile. And then I'd put you on my grudge list. Because it's really irritating to be told that. It's irritating because it seems to ignore the fact that, old or young, there's no guarantee. It's irritating because age isn't the only, or even the primary reason most of us move on. We move on because we can't keep going - emotionally, financially or rationally... and on the odd occasion, physically. If anything the older couple has greater emotional and financial stamina than the younger couple. And rationally - well, we'll both reach our "99% of couples your age should have conceived by now so you should move on" point sooner or later, and getting to that 99% mark sooner because I'm young won't make it easier if I'm left in that unfortunate 1%. It's irritating because when it comes to infertility being young doesn't count for everything. Not nearly as much as people like to dismissively suggest.

So I'll smile my brittle smile and if I'm feeling sarcastic I'll remark in a scathing tone that we should thank God for eensy, teensy, tiny, miniscule, "quick Bob bring the really really powerful and expensive electron microscope", more infinitessimal than any particle as yet discovered by science, very small mercies.

And then I'll go home and I will. Sincerely. With all my heart. Because, you see, it counts for something.

It means the luxury of taking a break, if we want. It means moving to plan B at our own pace, without the distracting sound of that loudly ticking clock. It means hope for new discoveries, new treatments, new technology, new solutions. It means choice, options, opportunities. I remember this sometimes, and I'm thankful for our youth.

I'm exactly as thankful as I should be.

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Summing Up

After reading through all the comments, I felt like making a concise summary of my now clarified viewpoint:

Saying, "Oh well, you're still young," is like saying a) don't worry - the problem can be solved given enough time (can it?) and b) it could be worse (thanks for that). One of a long list of things you can say to dismiss or diminish the experience of being infertile.

(In addition, in some cases it also implies that infertility is a wholly female issue, with no relevance given to the age of the father.)

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Since this has come up again, I'll add this. I'm supposed to start screening for breast cancer in 2007. This is because of a family history. Now, I may not get it at all, or I may not get it for years, but I'm nearly at the age where I have to start screening and it's giving me a bit of a ticking clock sensation. I think it's making me slightly more sensitive to being told "well at least you're still young" or, in other words, "never mind it could be worse". That said, I think I'm in basic agreement with Thalya.

Today was Mr Bea's birthday. Upon getting out of bed, I changed into my candy-pink, frilly G-str.ing and matching, half-cup, push-up bra, hidden coyly beneath an off-white, see-through, bum-length top, with the ties down the front left half-tied in what I judged to be a carelessly inviting manner. After breakfasting and unwrapping the gifts, I lounged back on the couch and gave a stretch filled with innocent suggestion. "So, birthday boy," I purred. "What do you want to do now?"

"Well, it's raining - not really the weather for going outside," replied Mr Bea. "I thought maybe the National History Museum."

(Later he claimed that because I am already at the limit of human desirability just pottering around doing the housework in my tracky-dacks, putting on lingerie and acting all sexy makes little change in his eyes.)

But that wasn't my only source of disappointment. You see this past week, as my good deed, I have been keeping an eye out for those boxes they have on counters at shops, supermarkets and cafes - the ones that collect what little change customers might casually drop into them for donation to some charity. I only found one. I think it was for the elderly. I know there are just as many in Singapore as anywhere else, and I can only assume I've spent the week shopping at places with low expectations of their customers. I think I'm going to have to continue looking out for them to make it worthwhile. Less of a good deed than I was hoping for the last of the year, but perhaps it's best just to let 2006 fizzle out quietly, so we can get on with the next thing. Which, as it turns out and as the title today suggests, is pretty similar to the thing we were doing before.

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I'm having internet troubles again, this time because of the earthquake in Taiwan. I can't comment at the moment, in fact I'm not sure if this will post. Email is still getting through, but it's all very slow. Anyway. It's not that I'm not thinking of you.

I've got this notion in my head where the 2006 section of this blog won't be complete unless I go back and fill in the blank that was the stim cycle we kicked off in January. I got OHSS. I thought I might tell you about it.

Then I wrote this long piece of self-indulgent drivel describing everything I can remember from the first moment I felt my ovaries twitch until the day of EPU, and it was kind of huge already before I even started on the bulk of the story, plus it was, like, months ago so who would be interested now?

Then it occurred to me that I was interested and it is, after all, my bloody blog, and besides what if someone drops by one day wanting to know something about OHSS and there's nothing here?

In the end I wrote this.

Risk, Reponse, Pain, Morphine,
Eating and Sleeping,
Raving, Relief, Forgetting

Risk
FS decided that, on balance, it would be best to go ahead with EPU and cancel ET, but that's not the only way we could have handled it. Some clinicians would have cancelled altogether, prior to trigger. Others would have been gung-ho enough to go full steam ahead. I remember the sense of relief I felt when I realised I didn't have to agree with his approach. I could set a lower level of risk. Ultimately it was in my hands. After due consideration I concurred, however, based on the high likelihood that whatever happened, I would recover.

Response
When I decided to take the risk, I promised myself I would not hesitate to get attention if needed. On the evening of the second day post EPU - the day I would have had my transfer - I unilaterally decided to go to the emergency ward at the local hospital. This was because I'd started vomiting. I handed FS's after-hours number to the young doctor who came to see me and asked her to call him to discuss my treatment, which she did. I was admitted.

Pain
After EPU I woke up feeling less painful than I had for the past week of stims. Two days later the pain was worse than ever. A week post EPU I was lying in hospital during my morning examination, when the doctor asked me where it hurt. I said, "Everywhere," and he laughed and told me this was not possible. Over the next hour or two I played a little game with myself called, "Does My X Hurt?" I started with obvious things: does my pelvic cavity hurt? Yes, of course. Does my chest hurt? Absolutely. (By this time I was on intranasal oxygen as I was having trouble breathing.) Then I moved outwards: does my right forearm hurt? Pinky finger? Scalp? I made a list of parts that didn't hurt. It was surprisingly short, and excluded many bits which had no logical claim to pain. I wondered if my sensors were simply so overloaded I had lost the ability to distinguish where my pain was coming from. It seemed plausible.

Morphine
At first I took morphine, and at first it worked. But as time wore on it became less effective. At the height of my illness, it took only the merest edge off my pain. But I started refusing doses before then, for this reason: it messed with my sense of time. After a dose I might close my eyes and try to rest. What seemed like an hour would go by and I would open them again to find only a couple of minutes had passed. I found I had to make a choice between enduring only 95% of the pain I would otherwise feel, but for a length of time which was subjectively four to ten times longer, or gritting my teeth and enduring 100% of the pain, but in real time. I kept changing my mind.

Eating and Sleeping
I couldn't. In truth, this started within the first week of stims, but it worsened until about a week post EPU. On my third day in hospital a nurse counselled me to force down a cup of milo - the most substantial thing I'd ingested since my arrival - because I was having a hypoglycaemic meltdown. It was good advice. I learnt that forcing myself to eat when I believed I couldn't was not only possible, but would make me feel better. It also helped me catch forty-five minutes of long-overdue sleep. I slept only about two hours a day, in two or three snatches, for the best part of a week. Mostly this was down to restlessness, pain and discomfort, although a week post EPU a night nurse spent some time pleading with me to get some rest, and I confided that my breathing difficulties were making me afraid to sleep. I was literally afraid I wouldn't wake up again. From this I gained the hope I needed to make it through - it struck me that things weren't so bad I wanted to die.

Raving
I told everyone everything without inhibition or regard. My sister (who visited me faithfully every night) gleefully rung me for several weeks after my discharge asking me if I remembered this part of our conversation, and sniggering and gloating when I admitted I did not. At one point I even showed her - up close and personal - my indwelling urinary catheter. She has reliable witnesses to back her story. This was a fascinating experience. It made me understand, for the first time, that the unforgivable things our mother said to us during her cancer treatment weren't merely the angry outbursts of a woman pushed to her limit. They were actual ravings, mad ramblings of which she genuinely has no recollection, and for which she can't be held responsible. I didn't understand this before.

Relief
A week post EPU they punched a paracentesis tube through my abdominal wall under local anaesthetic and drained off a small proportion of the fluid. The first breath I took afterwards felt so much easier I disintegrated into loud, racking, uncontrollable sobs of relief which brought enquiring hospital staff from nearby rooms and went on for a good ten minutes whilst the radiography nurse hugged me and passed me tissues. Twenty-four hours later I started having the curious sensation that I was deflating, like a balloon, and sure enough next morning's weigh-in confirmed that my weight had finally plateaued. During my hospital stay it had shot up by 25%. Fuck. That's a lot. When Mr Bea came to visit me the day after that, I noticed how much less tired he looked, and so did everyone else.

Forgetting
A few days after discharge I was lying in bed at home, enjoying, for the first time in almost exactly a month, the sensation of being able to lie on my side. Already I could feel myself losing touch with the physical reality of the illness I'd had. This speed of forgetting took my breath away. I told Mr Bea then I would do it again, if necessary. He looked startled, and hugged me tight, muttering platitudes about bridges, and crossing them. The final lesson was this: temporary physical pain is nothing to be afraid of. Only the permanent repercussions of our actions or inactions are important. The other day I looked, but I couldn't find my paracentesis scar.


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P.S. I have a big backlog of blogs to read today. Sheesh - it was only a weekend off! Take care - I'll get through them slowly.

Christmas. I guess it had to happen. And don't get me wrong, I'm glad it did, I'm just sorry not everything we wanted to happen "by Christmas" has, and yet it's here anyway, ready or not.

And... now I'm over it. Because I made some good decisions about Christmas this time around. I stopped treatment back in, what - end September? I let my "if it hasn't happened by Christmas" deadline go, laughing all the while at my naivety. I moved country - a measure which may be a little extreme for those who just want to make a quick getaway after the pudding. And there's one more thing.

In my family, we always had The Main Christmas Tree at my grandparents' place. It was where everyone gathered on Christmas morning to perform a little ceremony we called, imaginatively enough, "Christmas Tree" - basically a morning tea and the official exchange of gifts. The Christmas tree at my parents' house was a size down, and various other relatives who lived on their own or in pairs had little trees, just big enough for one or two.

This is our eighth Christmas together since we got married. And true to tradition we have always had a little desktop tree, just big enough for one or two. We were planning to upgrade, you know, as soon as we "started our family". Now I could bang on and on here about the definition of family, arbitrarily self-enforced hierarchies and the necessary re-examination of traditions over time, or I could just show you this:


And if you don't feel you can have a Merry Christmas, then at least let me wish you a happier new year.

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Other bloggers who are trying to enjoy Christmas despite infertility (and in some cases succeeding, to a greater or at least more drunken extent): Josie, Kir, Miss E, Katie, and Beagle.