My Cheap Violin

¡Ay, caramba!

2011-09-12T15:29:00.000+12:00

Life in Canberra has taken an unexpected turn. I find myself suddenly unemployed and undecided what to do next.

Things were just starting to go really well. I love my apartment, I have made some great friends. My social life has been full. I have been doing lots of sport and feeling healthy again. I really like Canberra. All was good.

Work was going well too. I was enjoying it despite the inefficiencies and idiosyncrasies of the organisation. And despite encountering a workplace bully (who I had chosen to ignore).

Sadly, things started to unravel in the last week amidst a hoard of contractual irregularities.

My NZ company engaged in this contract with company X, who in turn are contracted to supply doctors to a large Australian organisation. This made things a little more complex than usual. I work for my company, my company contracts services to company X, and company X contracts services to the client organisation.

It took five weeks for my company to get its first payment, despite me being sent a weekly payslip indicating that I was being paid by company X. The payslip had my name on it rather than my company's name and the money was actually being paid into the company account of the chief executive of company X. He was then supposed to be transferring the money immediately to my NZ company and paying the GST (goods & services tax) component directly to the Australian Taxation Office (I have seen no evidence yet that this tax has been paid).

Of course, he was failing to make all these payments, and my communications with him were answered with informal (and unprofessional) emails saying he "ABJECTLY apologised" and was just "really busy", and "what currency was my NZ company's bank account in?" and so on.

I became increasingly concerned about the legal implications of some of these ~~illegal~~ somewhat dubious processes. During my attempts to get matters sorted, the workplace bully made a complaint to company X about me. I'm not sure what the basis for her complaint was exactly. It was not about my work (which everyone acknowledged to be of a very high standard), but something along the lines of I had not observed the correct "chain of command" in dealing with my company's contractual negotiations.

She also indicated to people that she didn't think I "liked" her. As a result, a junior member of company X informed me that only 80% of my contracted duties were to be an excellent and highly skilled senior clinician...the other 20% of my work role was to "exchange pleasantries" with the practice manager (aka the bully).

This surprised me greatly, but as I had not yet seen the proposed contract, I was unable to dispute the correctness of this statement.

Despite multiple requests, I did not receive a written contract until midway through my 6th week of work. The contract was full of unusual clauses (eg. I sign away all my "moral rights" - um, do people actually sign things like that?) and did not even mention my company, you know, the legal contractor. It had incorrect addresses, incorrect dates, an illegal statement regarding the GST component of the contract and was completely inadequate. Clearly, I was unable to sign it.

Company X suggested I not come into work the final two days of last week whilst they sorted out the issues. In the meantime, my friends at work informed me that the bully had emailed everyone and said that I would not be returning. Ever.

So that, was that. The untimely demise of one of the most unusual work engagements I have been involved with.

I have already been offered other work in Canberra (from four different sources), and I do love my apartment...but, I'm thinking it may just be time to move on. I received a letter from my insurance company about my earthquake-damaged house in ChCh, and they are wanting me to engage an architect etc to start the quoting process and get a geotechnical engineering report.

All things best done with me in town.

*****

A series of unfortunate events

2011-08-28T14:59:00.000+12:00

I am sitting on my couch, sipping rose & french vanilla tea, and gazing out across Lake Burley Griffin watching a lone kayaker paddling in the sun-dappled water. Below me a cycling race is underway and from time to time a bunch of riders zoom past. A lovely Sunday morning in Canberra.

The peloton passing by...

I moved into my new diggs last Monday evening and I'm very happy. It's a fully furnished, serviced apartment with great views. The shot below was taken one morning during the week as I sat eating my breakfast watching a hot air balloon rise up over the lake.

Shouldn't every day start this way?

I've thrown in some photos of the apartment to satisfy your curiosity. The red rug in the lounge reminds me of a field of poppies. Or red mushrooms. It's very odd yet strangely appealing.

My Canberra lounge

I'm loving this kitchen!

Yes, that is a comfy bed...

There have been a few challenges associated with moving into this apartment. The first was the air conditioner. After two nights of waking at 4am cold, then getting overheated when I adjusted the temperature setting, I managed to download the user manual (thank you oh Internet of many wonders) and reprogram it.

My first attempt at cooking in the awesome kitchen required use of the internet too. The cooktop is a digital Miele convection one (which, by the way, is absolutely fantastic) and I had no idea how to turn it on. After downloading the manual I discovered it is a "touch" top and just requires your fingers in the right places. Very Star Trek.

It has not all been smooth and joyous sailing since my exit from SWF's part of town. I went out shopping on Friday night and managed to slip down one of those moving mechanical walkway things they have in malls. Somehow I landed flat on my face and badly scuffed my suede shoes and my pride.

The next morning I put all of my expensive silk and wool (designer) clothes on a delicate cold wash in the apartment's washing machine. They came out steaming hot. Steaming. The temperature recorded as 60 degrees celsius. Colour leach, wool disintegration, shrinkage...not knowing whether to sob my heart out or scream in anger, I stomped around in my laundry for at least a minute before deciding there was nothing to be done. No tanty, no matter how impressive, could bring back my Andrea Moore silk so I may as well move on from the trauma of it all.

After some speculation, I figured that the washing machine had probably been incorrectly plumbed, with the hot & cold taps interchanged, so I have now re-plumbed it and it is working just fine. A little late for my delicates, but.

Sadly, there was a third tragedy this weekend. My favourite Oroton sunglasses, the ones I wasn't going to bring to Australia because they were just too precious, fell off my head just as I was shutting the car door. It was one of those moments where you can see the sequence of events unfold in your mind before it actually happens, but you can do nothing to avoid the terrible outcome. My lovely sunnies were crushed beyond recognition as the car door slammed into them.

So, after that sequence of rather unfortunate events, I was instructed by my new BFF at work to remain indoors and try to stay out of trouble. So far, so good.

I nearly forgot to mention that I met up with Saleschick and she is just as lovely as her online persona :)

I can see yachts sailing out on the lake, so I'm off for a walk in the sun...wish me luck? Ciao!

*****

Tick Tock...

2011-08-14T20:26:00.000+12:00

Yeah. That's my ovarian clock ticking. It has become, quite unexpectedly, significantly louder since my recent birthday.

Speaking of birthdays, I had a lovely day. It started out with SWF annoying me in the kitchen (I am now absolutely certain she waits until she hears my door open before she gets up for breakfast...there can be no other explanation), and progressed into a busy day at work with the usual bureaucratic inefficiencies. I was drawn into a debate at the end of the day where one of the doctors who will be working here next year was lobbying for 30 minute appointments for all patient contacts.

Blanket long appointments are not necessary here. It is a ridiculous demand and would just add another layer to the inefficiency of the organisation, but, not my concern. I will go with the flow. The number of times she used the word "medicolegal" in her argument, just makes me suspect she lacks confidence in her clinical practice.

I told one person at work that it was my birthday and swore her to secrecy, but agreed to meet her for a glass of champagne after my massage and facial pampering session. As things turned out she also came with me to look at the serviced apartment I'm going to rent. It is fabulous and I can't wait to move in. Sadly, I have to wait another week before it's available.

One more week...I'm considering staying in a hotel whilst I wait. It is truly miserable staying here.

The birthday massage and facial were wonderfully decadent, and whilst I was there I went to the hotel reception, smiled a lot and suggested that I needed a room for my special birthday treat. The absolutely gorgeous young Indian woman working there gave me a luxury suite, with parking and breakfast included, for half price. I really liked her a lot.

It was a good night. Champagne. Feather down bed. Pillows to die for. Spa bubble bath. Solitude.

Oh, and thanks to the central heating, the first time since being in Canberra that I haven't woken up in the early hours of the morning cold and stiff. I was however, late for work the next day because I insisted on eating as much of the breakfast buffet as I could squeeze in.

It was hard to check out of that hotel. It felt like home.

Friday night I went out with a bunch of women from work. More champagne, I'm afraid. I had such a great time and laughed heartily at their stories all night long. A few of us went on to a wonderful French restaurant, and the food was delicious. I'm salivating just thinking about it now.

I only have one shelf in a small refrigerator (that freezes your food if you put it back too far), and a third of a shelf in the pantry, so I'm not doing a lot of gourmet cooking at chez SWF. I am also a little afraid to use her pots and pans because they are copper and must be polished after every use. I'm not exaggerating. Polished. Every use. These are the rules as conveyed to me by SWF. Who can be arsed with that?

There is also a strict, colour coding to the use of the plastic chopping boards, and I keep forgetting. Green is for vegetables, white for bread, yellow for chicken, blue for fish and red for red meat. I accidentally used the wrong board the other day and felt guilty as I loaded it into the dishwasher. Well, to be honest, it wasn't really an accident. The little yellow chicken board is the perfect size for cheese, and given that cheese is also yellow, I figured it would be ok.

My Saturday was consumed this weekend by an orthopaedic seminar which ran from 8:30am until 4:30pm, and then I spent the evening on my computer sorting out a tricky "human resource" issue related to a project I've been working on. So today has been my only day of rest (except for my laundry, ironing and other household chores) and it was nice to have the place to myself for most of the day.

Tomorrow I'm looking forward to meeting a Twitter friend, saleschick, after work. More champagne may just be in order ;-)

Getting back to that ticking clock. I have not decided exactly what to do about it yet, but don't worry, I will be doing something...

*****

Four Parts

2011-08-07T13:40:00.000+12:00

Ah, yes, well...hmmm. It seems as though people are still reading my blog despite my appalling inability to visit it myself. To say I am ashamed of myself would be somewhat of an overstatement, but I am experiencing some intense feelings of guilt when I remember my lack of writing.

Thanks for all your comments on my last post, and my apologies for disappearing on you all. I was surprised to see my "crush letter" had shot up out of obscurity to have over a thousand recent hits, but then I realised that True Blood was back on TV and doctor Google was leading the unwary Alexander Skarsgård fans to my blog.

In order to compensate for my prolonged absence and salvage the remnants of any readership I may have left, the following novella is a summary of my hiatus.

Part One: Road Trip

Kaikoura, NZ

I left off my last post with a reference to my intended mini-break which was meant to take the edge off my postmodern existential mini-crisis. And that it did. Almost immediately in fact, which I attribute to the amazing drive up the Kaikoura coast. It is one of my favourite drives in NZ, although almost anywhere you go in this country is pretty damn breath-taking. I love the clear sunny winter days when there is a dusting of snow on the mountains and a brilliant blue sea, and it all hits you in one perfect moment as you drive over the hill into the Kaikoura township. Sweet.

I decided to drive to Wellington due to the Chilean volcanic ash cloud that was interrupting air travel in NZ. It was a good decision to take a road trip. The ferry crossing was very relaxing, with dolphins swimming alongside and pikelets with cream & jam in the Kaitaki Plus lounge.

I stayed with friends and family in Wellington and the Kapiti Coast for about a week and then headed home again, with a stop-over in Kaikoura to catch up with a friend there.

During my road trip I was contacted by an organisation in Australia asking me to work for them until the end of the year. After they acquiesced to all of my outrageous demands, I had little choice but to accept their offer.

Part Two: Brave New World

Icing on the Quake

Shortly after my arrival home I got sick. Not man-flu, common cold type of sick, but high fevers, muscle aches, joint pains, can't get out of bed for three days sick. It was very inconvenient, and I am blaming the Whitebait omelet I had for lunch. [SWF insists it was influenza. It wasn't, I am immunised.]

In the final days of getting organised for my trip to Australia, it snowed in Christchurch. 30cm. It hasn't snowed here in 15 years. Snow on the beach is just plain weird. The photo above is the view I woke up to from my front door.

Yeah, it was kind of pretty, and I felt like I was a tourist somewhere exciting, but shoveling snow from my driveway so I could get my car out kind of took the shine off the holiday spirit. Also, the strange creaking noises coming from my roof were a little alarming (you may recall that the support beams in my roof have split and bowed from earthquake damage, and that the concrete tiles have already slumped).

The council decided that if you had more than 20cm of snow on your roof, you should probably clear it off, if you could do so safely. Without climbing onto my roof with my 30cm ruler, I estimated that I had about 20cm of snow on my roof. I also estimated that the probability of my being able to safely remove snow from it was approaching zero, so I left it and waited. And then I left the country.

Part Three: Sense & Sensibility

Welcome to the Dollhouse

On arrival to Canberra I was met at the airport by one of the doctors I will be working with and he drove me to the house where I would be boarding with a woman whom I had never met. We have mutual friends, and have been Facebook acquaintances so it seemed a reasonably low risk scenario. Her first words to me were "Oh, I thought you'd be a blond" (I have just had my hair darkened a little). Apparently, she thought living with a blond would attract more men into her life.

I was greeted in my tiny bedroom by three giant stuffed animals (a wombat, a teddybear and something resembling a flattened dog) which totally consumed my double bed. The one item of furniture in the room was similarly consumed by the dolls above. Yes, I took photos. How could I not? It was so bizarre.

It took me several days to get all the toys re-homed, but even then the room is still pretty tiny.

Even with the snow at the home, Canberra was much colder than Christchurch when I arrived. My first morning run was also my last after returning home to find the temperature was -8 celsius (17.6 fahrenheit) and that my legs had turned into two frozen popsicles. It seems sensible to postpone early morning runs until Spring.

I did join a local gym and went to a spin class as part of my cunning plan to improve my cycle fitness. It was much harder than I had anticipated. I hadn't realised there would be so much standing "hill" work, and my poor weak legs just got up and walked out on me. I do plan on going back again. Just, not yet.

One must be sensible about these things.

Part Four: War and Peace

I have now completed my first week at work. I am full time doctoring until Christmas, but it is pretty much 8-4pm with no after hours responsibilities (unless I choose to do some call), so it should be quite manageable. The administrative side of things will be a constant headache, but that is to be expected with the organisation I am working for.

Things haven't been going so well with my living arrangements. For readers who don't understand the term "boarding", it just means I am renting a room and use of the house facilities in someone's home. I made two assumptions before accepting the offer to board here; the first being that the woman I would be living with is very busy with her high-powered job that she would never be home and would have her own developed social life; the second being that I could tolerate living with a stranger for 5 months.

Both assumptions are incorrect.

I've only been in Australia for 11 days, and I am already finding reasons not to come home. No matter what time I get up, this woman gets up at the same time and wants to small talk (side note: I am not now nor ever will be the sort of person who can manage small talk first thing in the morning when I am running late for work). I had started changing my morning routines to try and avoid her, and this was my first red flag that things weren't going to work.

She is always home when I get home. If I go to my bedroom when I arrive home from work to get changed or check email, she will be knocking on the door (and opening it) within moments of my return. She wants us to cook and eat together but we like completely different types of food (out of politeness I waited until after 8pm the other night for her to make a really bad risotto when I had been starving & ready to eat at 6pm). She took me to a food market last weekend where "we" bought a lot of food that I don't really want to eat, and the food suggestions I made were largely ignored.

There is a TV in the living room, and she has shows that she watches every night (fair enough, it is her house), but none of them interest me, so I will only get to watch a show I like if she's out (which appears to be an infrequent event). This probably wouldn't bother most people, but I am a TV addict, so it's been a tough wean.

There are other things that bother me. I am a power conserver, I turn off lights if not in the room and those types of things. My housemate has every light in the house on, a radio on 24h per day, the dishwasher goes on daily even if less than a 1/4 full, laundry loads are always less than half full (and there is nowhere for me to hang my laundry if it is wet outside), things like that. It may bother me less if I wasn't paying half of the electricity costs.

I was telling the pharmacist at work about a few of the odd things that have happened (like surveillance of the breakfast dishes to see what I have eaten, and voiced bewilderment when I had left said dishes in my bedroom for the day), and she immediately labelled my housemate as a "Single White Female" (SWF). I laughed and said no, that's not it, she's just trying to be nice but a bit over-the-top involved in my life. However, she will henceforth be referred to as SWF because it's easier to write.

The Movie

When I got home from work that very same evening, SWF knocked on my bedroom door to show me her new hairstyle. A hairstyle that was identical to my own. It did give me the heebies a little given my earlier conversation, but I'm sure it was just coincidental. Has to be.

I realised yesterday, that I am only here in Australia to have a break from the disruption of all the earthquakes in Christchurch. I am an earthquake refugee (that the Australian government has graciously allowed into the country instead of forwarding to a Malaysian processing unit). I'm not here to collect a big fat pay cheque (although this is a happy consequence of events). I am here to relax and recover from an ongoing natural disaster. Not to mention my IVF supernova.

So, I am now looking for an apartment where I can live by myself and indulge in all my own quirky little behaviours that make me happy. Like sitting in my PJs writing in my blog, or talking on the phone, or watching shows I like on TV. Where I can look forward to vegging out after work, doing want I want, when I want, and eating what I like, when I like. You get the picture.

Rentals are scarce and very pricey here in Canberra, but I realised that even if I lose $10,000 in gross income so that I can live in a lovely apartment, it is money well spent. Because it is spent on my happiness.

The best thing that has happened to me since arriving in Canberra is to have found a little boutique gym under one of the hotels where I can go swimming. I've only been twice so far, but it is totally wonderful. The pool is snuggly warm, and although there are only two (extra-wide 25m) lanes, each time I've swam, I've been alone in the pool. I have then sat in the spa pool for 30min before taking a long time getting showered and dressed in the empty, luxurious change rooms. Bliss.

SWF informed me last night that it is my birthday next week (stupid Facebook). I told her that yes, I was aware of this. I have now decided to book a spa package for after work that day, go out to dinner (by myself) somewhere really nice, and come home late. Or I may book into a flash hotel. We'll see.

*****

The Lull

2011-06-26T15:26:00.000+12:00

It's never too late to be what you might have been.

George Elliot

Source

I have been absent from my blog for a while now. I have been stuck in the lull. The absence of happening that has sprung up between my fertility woes and the havoc wreaked by Canterbury's earthquakes.

I've been tired. I've been a little sad. I've been experiencing a postmodern midlife existential mini-crisis. Or what I like to consider as my WTF? period in personal evolution.

I have come to a fork in the road and I am re-evaluating what it is that I actually want from my life. What do I want to do next? Who do I want to be? I've lacked the motivation to move forward because I'm not certain which direction I want to head in. So I am stuck. Temporarily. Here in the lull between deliberate and passive being.

I find it equal parts amusing and equal parts alarming that at 40 years of age, I am still wondering what I want to be when I grow up. My own personal tragicomedy.

Since losing my job to the February earthquake, I have been pursuing other work opportunities. For some reason, nothing has fallen into place. These pursuits have caused major stalling in my momentum, and I am beginning to wonder if this is a symptom of discordance? Perhaps I have been pushing in the wrong direction?

I have decided to take the next week "off" from my life, visit some friends, and focus on a few of my personal commandments: love being me, act how I want to feel, and let it go.

I figure a mini-break will defeat a mini-crisis any day of the week.

*****

They built this city on rock & roll

2011-06-15T23:03:00.000+12:00

I woke up this morning with an equestrian helmet sitting on the pillow beside me.

My first thought: waah? Then I recalled the 6:30am wakeup by the magnitude 5.0 aftershock during which I leapt out of bed, placed the helmet on my head and then apparently left it sitting on the adjacent pillow after I crawled back under the warmth of my covers (once I knew my roof wasn't going to collapse).

In over 7000 quakes since last September, I have never once placed my riding helmet on my head. Until now. Apparently.

Christchurch has had it third major earthquake, another 6.3. Yawn. More collapsed buildings, more liquefaction, more power cuts, more contaminated drinking water. Thankfully, no more dead.

During this particular earthquake, I happened to be in the middle of washing my hair. In my glass-walled shower. A glass shelf fell down and glanced across the back of my head before crashing to the floor. The walls of my shower, of my bathroom, flexed and moved like I was in a 3-D movie (or on drugs) whilst I rode the wave of the quake. I managed to run out through my house, wet, naked and heading for the dining table before the intensity of the shaking started to ease. Luckily I had time to put a robe on before my neighbour was at my back door asking if I was ok.

Yes, I am ok. We are all ok. Kind of. But not really. How can anyone be ok here in Christchurch?

My dining table has no chairs around it so that I can take cover under it quickly. My large bookcase lies on it's side in my lounge where it has been since the February quake, empty of books. My spare room is full of boxes of belongings, half-packed. Unable to be out on display. I walk around my house, going up and down in altitude with each step due to my wonky foundations. I have torches placed strategically around the house to grab in the dark. My survival kit inhabits my hall. The concrete tiles in my roof sag unnervingly. I can't open windows, I can't close doors. Spiders have made their homes in the gaps between my walls and my ceilings.

There is a riding helmet on my pillow.

My muscles hurt from shoveling water laden liquefaction silt off my lawn and driveway yesterday. Again. I know the sand volcanoes beneath my house have been joined by new ones. I don't need to look under the floor to know this, I could see them oozing out from under my foundations.

We all wait. We wait to find out if our homes will be demolished, or repaired. The lucky ones, like me, can live in our homes whilst we wait. I have power again. I have water that can be boiled now that the sediment has cleared; many do not. I am very fortunate, I have a toilet that can be flushed sparingly, some must use a hole in their garden. Or a port-a-loo on the street.

What to do? Nothing can be done.

The three largest earthquakes (7.1 4th Sept, 6.3 22nd Feb, 6.3 13th June) have originated in three different fault lines. Three different, previously unknown fault lines. What this means is that we can't rely on theories of pressure being released from faults leading to fewer, less intense aftershocks. We don't know how many other faults are out there beneath the Canterbury plains. Waiting. Pressure building.

It seems logical that the first earthquake has triggered these other faults into action. But no one knows what may come next. The geological experts say we have a 30% chance of another "big" earthquake in the next year. What does this even mean? I'm not sure they can use statistical probabilities here, because really, there is no historical data to call on. Predictions are meaningless.

For years, geologists at Canterbury University have been writing about the risk of the Alpine fault shifting and releasing a massive earthquake that would impact on Christchurch. They say it is due. It hasn't happened yet, so I guess it is still due.

I remember the first earthquake, in the middle of that cold night, back in September. At that time I wondered out loud to my neighbours, could this have been the "big one" in Wellington and were we just feeling the resonance? I grew up in Wellington. We have earthquakes there. We expect earthquakes there. Only the geologists expected earthquakes in Christchurch.

So, after my IVF collapsed in on itself last week like a dying star, I can't help but wonder if the gravitational field of the resulting black hole may have triggered this latest fault into action? But, that would be rather egocentric wouldn't it.

Yes, there have been aftershocks whilst I wrote this post, but I don't get off my couch for anything less than a magnitude 5.0 these days.

*****

Show me the Sperm

2011-06-12T14:29:00.000+12:00

Every sperm is sacred, every sperm is great, if a sperm is wasted...

Monty Python

A lot of people have asked me why I don't just get another sperm donor. This post is to explain why it's not quite that easy.

Courtesy Google Images

The Donation Process

In NZ, the sperm donation process consists of the following steps:
1 - Decision to donate (donor must be <45 years old)
2 - Medical check up including blood tests and sexual health swabs
3 - Counseling
4 - 1-2 sperm samples for bacterial culture and freeze/defrost test
5 - Multiple subsequent samples which will then be quarantined for 3 months before use

The entire process usually takes about 6 months. (Of note, genetic disorders such as cystic fibrosis etc are not screened in donors).

The Impediments to Donation

1 - In NZ, like in many other countries, it is illegal to remunerate men for sperm donation. There is no financial reimbursement for travel costs, time off work or anything else. This means that donors donate for altruistic reasons only. A man must therefore be prepared to spend a lot of time in the process with the only compensation being the knowledge they have helped out an infertile woman/couple.

2 - There is a mandatory donor register which records the donor's details so that they can be contacted at a future date by any children born from their sperm. This lack of anonymity can put some men off.

3 - The vast majority of the very small number of men who donate their sperm in NZ choose to exclude single women and lesbians from using their donation.

4 - There are no advertising campaigns, or "sperm drives", so a lot of lovely, caring men out there who would be happy to donate, have never had the option enter their awareness. It's not the sort of thing people talk about.

5 - There are complex laws surrounding importation of human tissue into NZ, but even if I could import sperm the mandatory donor registration would rule out all countries where donation is truly anonymous (like the USA). I have looked at some of the US sperm bank websites with utter envy. So many options for you US ladies...if only it could be that easy here.

The Bottom Line

What this means for someone like me is a 2-3 year waiting list to get an anonymous sperm donor. And then, I would be offered one donor sample. I would have no choice in selecting a donor with specific characteristics. I would get what I was given.

The sample would most likely only be enough for IVF/ICSI because it would be "left overs" and not large enough in numbers for IUI. (I don't know this for certain, but this was the situation at my clinic 3 years ago when I first began this process).

This is not an option for me. My 40 year old eggs cannot wait 2-3 years and I cannot accept having no choice in who my donor is.

What Options Do I Have Then?

I could look for another known donor. This is not easy though as I don't know anyone I could ask, and even if I did, I don't know that I would ever be able to ask. As I mentioned in earlier posts, my current donor offered. He and his wife are good friends who knew I had been knocked back by the clinic for anonymous donor IUI, so after a lot of thought, they offered. I would never have asked them.

It then took me almost 6 months to decide to accept their offer. It's a big decision when the donor is someone in your life. It makes things a lot more complicated. Then it was another 6 months before I could actually start my first IUI.

There are 3 clinics in NZ, and there isn't a lot of difference between how they operate - the doctors all trained together after all. I could move to Australia and do fertility treatments there, but they also have similar issues with sperm donation, so there is no guarantee I'd be able to get a donor there either.

I could enter the world of fertility tourism. Perhaps a turkey baster tour of the world? Or I could spend an enormous amount of money and go to a fertility clinic somewhere in the Northern Hemisphere where they don't have a shortage of donor sperm.

The easiest way for me to find a new donor, is to pick one up in a bar.

*****

One door closes...

2011-06-09T13:05:00.000+12:00

The chief beauty about time is that you cannot waste it in advance.

Arnold Bennett

My heartfelt thanks to all the lovely women who wrote beautiful comments on my last post and sent me messages on Twitter. It was so wonderful to have all of your support. Thanks also to my in real life friends who read this blog and have sent me kind messages. You know who you are and I do wish we lived closer!

It's very difficult for people who haven't been through fertility treatments to understand the emotional blow that comes from this type of failure. All those wasted eggs. All that wasted hope.

After the shock and disappointment, there is no anger or frustration. I just feel tired. And empty. I think I need a holiday on a beach, somewhere in the sun.

Several of you have commented on how the clinic let me down as they should have been monitoring things more closely to allow for ICSI as a back-up option. I had thought this would be the case, but I should have clarified that further. There are only three clinics in NZ and I don't think they do things any differently in the other two.

I don't see any benefit to me in being angry with the clinic.

I'm not sure I can go through another treatment cycle. I had always believed that I was fertile*, but with the repeated IUI failures and everyone blaming my egg quality, I started to doubt myself. I wish that someone had questioned the sperm quality at some point in the process.

I could do an ICSI cycle, but what if the sperm is not right genetically? Remember I had an early pregnancy loss in IUI#2. Maybe that was due to the sperm's DNA? I'll never know. I just don't want to invest all that time, emotion and money in an ICSI cycle only to find the embryos are no good. The trust is gone.

I also wonder if it's time I listened to the universe and accepted that this donor is just not meant to be the biological father of my children.

So, I am closing the door on my stored sperm, and I will look forward to new doors opening.

* There is still no guarantee that I am fertile, but as things stand, it seems quite likely.

*****

The Price of Fish

2011-06-07T18:50:00.000+12:00

So long, and thanks for all the fish.

Douglas Adams

I was planning on writing a different post today. One that talked about embryos. Not one that talked about dead fish.

Google Images

I woke up with the ringing phone this morning and knew immediately that it would be the embryologist. I was a little surprised that it was the head embryologist as she had indicated that it would be someone else calling. I asked her "so, how many did we get?" in a very excited tone.

The pause told me everything I needed to know. None. Zero. Zilch. No eggs had fertilized.

Of my 11 eggs collected, one was immature and one was missing it's nucleus. The remaining 9 were perfect to behold. Or so I am told. What no one was expecting, is that when they went to check on them this morning, the sperm were all dead.

One sperm was adhered to the side of an egg, as if he had tried his damnedest to do what he had been born to do. But he just didn't have the gumption to break into that lovely egg and drop his genetic load.

It was all too late for ICSI (which I had been talked out of because it "wasn't needed in my case"). By the time the terrible truth had been discovered, my eggs had lost their magic.

I have had three calls from the clinic today. No one had expected this. This is not something that happens. I was told less than 1%, and even then it's usually with couples who have unexplained infertility. My sperm donor had no problem conceiving his two young sons. There had been no reason to suspect that his contribution was one of defective sperm.

Now it is clear to everyone that all my IUI cycle failures were the fault of the sperm. One and a half years of active fertility treatments, 9 IUIs, 1 IVF and $25,000 to be told "hey, at least now we know you're fertile!" Priceless.

I have had an image in my head today of hundreds of thousands of sperm lying there on the petrie dishes like fish washed up on a beach. Flapping around uselessly as they slowly succumbed.

Apparently they looked fantastic when they were defrosted & introduced to my eggs yesterday afternoon. But, that makes no difference now. They were missing some vital ingredient. Chemicals? Energy? Genetic stability? Who cares. They lacked the goods required to find their way into my perfectly good eggs.

And that is all that matters.

So, I am in a new place. New decisions, new paths, new options. There is a 2-3 year waiting list for an unknown donor here, so that is out. I still have some frozen munted sperm for an ICSI cycle, but the trust is gone.

I am thinking of random sex with a stranger. Better odds.

*****

Eight

2011-06-02T12:04:00.001+12:00

Courtesy Google Images

Today is day 8 of my FSH stimulation injections and I am now totally over the needles.

I've been pretty lucky though and have experienced very little in the way of side-effects. The odd spot, the odd headache, but certainly no raging hormonal mood-swings or tantrums like I was anticipating. I wonder if this is because I don't have a partner hovering around irritating the hell out of me?

Maybe it's just because I'm feeling relaxed and happy about things in general.

On the evening of day 6 I noticed something unusual going on in my pelvis and by the morning of day 7, I felt like I needed support undies to hold in my ovaries as I waddled off to my USS appointment.

Those of you who follow me on Twitter, will be aware that I had been making some pretty bold statements about my plans to have 8 follicles on each side. I had been doing my Circle+Bloom mind-body relaxation program, and then playing my ovaries Grieg's Peer Gynt, Morning Mood and picturing the little eggs in my follicles dancing away like little ballerinas.

So, I was feeling rather smug when the scan demonstrated 8 juicy (14mm) follicles on the right, and 5 of the same size on the left...plus three little ones! My ovaries had followed my instructions brilliantly and made me 8 follies each side. On ya girls!

I could almost hear SW* and the other fertility clinic staff breathe a sigh of relief. SW told me that she was hoping for 5 or 6 follicles in total, but had been worried I might only make 1 or 2. Well, I showed that these ancient ovaries are not out of the game yet and everyone was quite excited.

For the first time, SW started talking about day five transfers. She had been very hesitant in discussing embryo transfers previously, and now I realise why. She hadn't been certain there would be any embryos to transfer at all. Now the odds are in my favour. And the gods presumably.

The reason I had instructed my ovaries to make 16 follicles in total, is actually related to a recent study published in Human Reproduction that looked at the association between the number of eggs retrieved in an IVF cycle and the rate of live births. The authors analysed data from 400,135 IVF cycles performed in the UK between April 1991 and June 2008.

Yes, you read that correctly, over four hundred thousand cycles! This is a lot of data and lends their findings significant statistical power. Their results demonstrated that the live birth rate rose with increasing numbers of eggs retrieved until 15, then plateaued between 15-20, and started to fall again beyond 20.

This means that, statistically, the optimal number of eggs to have retrieved in an IVF cycle to give you the highest "statistical" chance of having a baby, is between 15-20.

Their data shows that the predicted success rate for a 40 year old woman who has 15 eggs retrieved is only 16%. This is not a number I am particularly impressed with.

What isn't demonstrated by this study is the breakdown of IVF cycle protocols. Is there a better protocol with a higher success rate that is independent of number of eggs retrieved? For example, are there protocols that improve the endometrial receptivity, or the embryo quality? This study only looks at overall IVF population statistics and in time I suspect this data will be broken down further.

In the meantime, I am excessively happy with my 13 good-sized follicles (and the 3 little ones that may still catch up). If I get 13 eggs harvested (assuming I have no empty follicles, and I don't, because I have been watching their ballet!), and fertilisation follows statistical expectations (about 60%), I could be looking at close to 8 embryos.

The quantity is good. Now it comes down to quality. Let's hope that all my egg rejuvenation measures will make me proud!

* SW has taken over as my fertility specialist now that she is back from overseas. She is a personal friend and is also close friends with my support person, J.

*****

Who likes bicycles?

2011-05-30T11:29:00.001+12:00

One of the things that makes me the happiest, is riding my bicycle. I only started riding a few years ago, and I took to it like a duck to water. I love my Giant roadbike. Love it.

There is nothing quite as invigorating as taking the Giant out for a blat and enjoying the beautiful NZ countryside. And as an added bonus, cycling is great for shaping sexy legs.

This is my beloved:

Giant Ladies OCR C2 2007 model

Sadly, I haven't been out riding as much as I would have liked this year. Partly due to the earthquakes, partly due to some ongoing weakness from my accident that makes hills a lot harder than they used to be, and partly due to procrastination.

My Giant is a bike for semi-serious cycling. It is not really the kind of bike you ride on errands to the local shops, or about town. For two reasons: firstly, it's expensive and I don't want it (or pieces of it) to get nicked, and secondly, normal shoes will slip on the pedals without cleats and who wants to walk around in cycling shoes whilst they do their shopping?

In line with my views on lowering individual carbon emissions* and staying physically active for health, I am thinking about buying a new bicycle. I could do with an "about town" bike, and to be honest, it needs to be both functional and kinda cool.

I love retro bikes, so I have been checking out a few on line that may suit me. Yes, I want a comfy seat, a lady's frame so I can wear skirts, a basket for my shopping/handbag, and possibly even a kickstand.

Here's one of my favourites so far (it's a six speed, which isn't really necessary, but its pretty darn cute). I'm not sure if I can buy it in NZ, but I can pick one up quite cheap in Australia:

Ruby Belle

How about this one (3 speed), I know I can definitely get it in NZ...

Electra Amsterdam

My cousin in the UK has an awesome Dawes' bike, and I really like the look of this one, but again, not so easy to come by in NZ:

Dawes Graduate

Now, here in New Zealand, we have a law that states all cyclists must wear safety helmets. The police will pull you over if they spot you without one. There is a lot of debate around the world as to whether or not helmets will actually save your life in an accident, but there is no question that they will save some of your skin. And, besides, it's the law.

There is also no question that helmets will cause hat hair and are generally not so fashionable. As a law abiding citizen, torn between wanting to look excessively glam on my new town bike but not wishing to be a poor role model to young children as I swan past them with my unfettered locks trailing behind me. A friend has kindly provided me with a link to the Yakkay range of helmets, which could be a more stylish alternative to my current Giro.

Yakkay Cycle Helmet

The only problem with the Yakkay's, is that I'll still have the inconvenience of the police pulling me over, I just won't have the hefty fine.

Help me find my new bike! I'd love to hear any of your recommendations or links :)

* In one of my lives I promote understanding of the implications of climate change to health. If you don't "believe" in climate change, then I suggest you do more research. The debate is long over as to whether or not climate change is happening, and the ongoing denial that it is human-made has been over-whelmed by strong evidence. The Skeptical Science website is a good place to start if you have questions.

*****

A Little Endocrinology...

2011-05-28T13:16:00.000+12:00

I got a little lost this month on where I am in my cycle. This is because of the Buserelin downregulation injections I have been taking which mean that CD1 was not really CD1 because there was no natural FSH being released from my hypothalamus.

What's a hypothalamus you ask? This is an area of the brain that produces regulatory hormones in the body. Hormones are really just chemical messages that tell our organs to start or stop doing things. The system of glands and hormones in the body is known as the endocrine system (which is why in many countries fertility specialists are Reproductive Endocrinologists. In NZ they are mostly Obstetricians).

The hypothalamus is pretty much the "lord of the endocrine glands" and sends messages to the pituitary gland (also in the brain) to send out organ-specific hormones. Two of these organs being the ovaries.

Source

For control of the female reproductive pathway, the hypothalamus makes GnRH (gonadotropin releasing hormone) which in turn stimulates the anterior pituitary to release FSH and LH.

Source

The Buserelin I have been taking is a GnRH agonist. This means that it mimics natural GnRH and swamps the pituitary with messages to make FSH & LH. Initially the pituitary complies and you get a surge of these two hormones, but with continued administration (after about 10-12 days) the pituitary gets desensitized and you get a profound suppression of the hormones.

This is a little different form the GnRH antagonists that are also used in IVF. Those drugs are similar enough to natural GnRH to fool the pituitary into thinking that's what its getting, but the message is "off" so no FSH or LH gets made at all. The natural GnRH can't get a word in because the antagonist has swamped all it's receptors on the pituitary. These drugs switch off production straight away as opposed to the slower downregulation of the agonists.

So, why do we do it? Why do we shut down our hormones like this? Basically, to get a blank slate. We dampen down our ovaries so that when we start stimulating with high doses of artificial FSH injections we will (hopefully) get many follicles growing at the same rate and stage of development. (There is more to it than this but this is the general idea. There are also some IVF protocols that don't downregulate, but I don't know much about them).

~~~~~

So, back to ME. I downregulated with 400mcg of Buserelin for 11 days and then my blood test showed my oestrogen levels were zero, so I reduced my Buserelin dose to 200mcg to keep me in a "holding pattern". I will stay on this dose of Buserelin until the morning of my ovulation trigger shot (which will be Ovidrel) to prevent me from ovulating early.

I could have started FSH stimulation injections when I reduced my Buserelin, but due to my clinic preferring not to have egg retrieval on the weekends, they made me wait until Thursday to begin my Gonal-F injections. Gonal-F is follitropin alfa, which is simply an artificial FSH. They also like us to split the injection timing (Buserelin in the morning, Gonal-F in the evening), but this is just a historical practice to avoid confusing the two shots.

Tonight will be my third Gonal-F injection at a dose of 300iu. This is the highest dose my clinic uses, and I am getting it because I'm 40. I know they use higher doses overseas, but the clinics in NZ tend to be conservative due to the risk of ovarian hyper-stimulation syndrome.

I expect to have about 10 days of FSH injections before triggering for the egg retrieval which will take place 36 hours after the Ovidrel injection. Next Wednesday I will have a blood test and USS to see how many follicles have started to grow and what size they are. This will give me a better idea of when my egg retrieval will be likely to take place.

I have decided to take today as CD4 and pretend that I started stimming on CD2. Why is the cycle day important to me? So that I know which session of my Circle+Bloom mind-body programme to listen to!

*See fertility glossary page for any definitions

*****

Manukura

2011-05-25T17:13:00.003+12:00

I've been pretty busy the last couple of days, if you include sitting on my butt cross-stitching a Winnie the Pooh picture for my future nursery, so not much time has been left over for blogging.

I am 12 days into Buserelin down-regulation hormone injections and apparently my oestrogen levels are now 0.0, which surprises me because I am being particularly girly at the moment. I thought I'd be good and inject a different site, but the needle bounced off my belly twice (abs of steel?) causing considerable pain without penetration, so I am back to my numb thigh shots.

Today was the first day that I really noticed any side-effects (headache and nausea), but they may have been related to being awake from 5:30am (earthquakes) and then going for a swim with my neighbour before breakfast.

I start on my FSH (Gonal-F) stimulation injections on Thursday, and it looks quite likely that my egg retrieval will be on Monday 6th June. An interesting aside is that this will be Queen's Birthday (public holiday here in NZ) and it was QB 3 years ago that I was carried off to ~~Guantanamo Bay~~ the hospital for my one month sojourn on the neurosurgical ward. The universe is being a smart-arse again and I see this as a very positive sign of my moving forward. And getting busy living.

So, enough about me. As part of my happiness project, I have decided to start posting something every week that makes me happy. This week the honour goes to this story...

On the 1st May 2011, a special little kiwi chick was hatched at Pukaha Mount Bruce National Wildlife Centre in the Wairarapa, the lower North Island of NZ.

He has been named Manukura, which translates in Maori to "of chiefly status" and Manukura is a very rare white kiwi (not albino) born of two North Island Brown kiwis (aka mum and dad).

Courtesy of Pukaha Mount Bruce National Wildlife Centre

I thought I'd take this opportunity to mention a few facts about Kiwis:
- They are found only in New Zealand.
- They are the national bird of NZ and lend their name colloquially to the people of NZ.
- They have wings but cannot fly (this is pretty common with NZ birds due to a lack of predators for many thousands of years until humans came along...).
- They live in burrows in the ground.
- They use their long beak to root around in the mulch and dirt for bugs and worms to eat.
- They mate for life.
- Their numbers have been decimated since the arrival of predators (mainly stoats and possums) so that now they are endangered and it is thought up to 95% of chicks will be killed in their first few months of life.
- Their eggs are larger in proportion to their size than any other bird (20% of the females body weight, see the skeleton/egg picture on this page!), so only one at a time. The male incubates the egg for a few months. You can understand why they are dying out.
- There are two species, Brown and Spotted, with six subspecies remaining.

You can learn more here.

Below is a short video to show you just how cute little Manukura really is! I hope it makes you as happy as it makes me :)

Courtesy of Pukaha Mount Bruce National Wildlife Centre

Manukura, a sign of good things to come...

*****

Words

2011-05-22T14:46:00.000+12:00

I met a friend for coffee yesterday, and she reminded me of my time working in paediatric oncology. So when I woke up this morning (after J had text me to say "nice photo" which is, by the way, pretty unflattering and very prominently on display in the centre of the page) I started thinking about an experience I had during that time, back when I was a paediatric resident.

Out of the millions of moments that occur in the practice of medicine, there are a small number that stick in your mind and resurface from time to time. For me, one of these branded memories concerns a three year old boy, H.

He was a tough little kid. He had been in hospital for so much of his young life that he was jaded with the world. And cynical. He spoke like an adult, and it was hard to remind yourself that he was just a preschooler. He seemed as old as time.

What I remember most about him is that I spent a lot of time trying to extract a smile. This wasn't usually a challenge for me with children, who tend to laugh at me the moment I enter their awareness, but H didn't smile a lot. He didn't trust new people, and he didn't find medical staff all that funny. I did receive a fleeting smile from him once, but it didn't last.

The memory that has stuck with me and returned to haunt my morning wake-up, is of late one night when I was in his room adjusting his morphine dose. He was in a lot of pain. It was deep in his bones. He moaned and writhed quietly, and sobbed a little as I rubbed his legs to try and give him some comfort.

What punctuated this moment in my memory was when his mother, who had been asleep on a cot in a corner of the room, sat up and yelled "H, SHUT UP!". She then turned over and appeared to go back to sleep.

I was angry and horrified with this woman's behaviour. But, with much thought over the years I do understand it. She was tired and she had her own pain to carry. If she hadn't have loved her son, she wouldn't have been there. Still, this doesn't excuse the way she spoke to him whilst he suffered.

If H had survived, this memory of his mother yelling at him when he was in pain would have been something he carried with him for life. He died a few days later, so it is his mother who must carry that memory with her. And I.

Why did I write down this story? As a reminder to myself, and to you all, that we never know when our last moments will be spent; when our last words will be voiced, or what lasting impression they will have on the people we love and the world we leave behind. Even more important, are the words we choose to say to our children. Words that will carry them wherever they go in life.

Be kind. It costs so little and gives so much.

*****

Hi, Society.

2011-05-18T14:27:00.000+12:00

Yesterday I was photographed for the society pages of the Sunday paper. My good friend J is very excited about this, as I will be the first person she knows personally to be in them.

Society's latest It Blog: My Cheap Violin

I, myself, am completely mortified.

Yesterday morning I had slept in. Late. I couldn't be bothered putting on any make-up, or doing my hair, and after planning a stylish wardrobe in bold red, I ended up opting to comfort dress instead and wore my grey knit hoodie over my jeans. What was I thinking? Well, I was thinking that we are pretty casual types here in little old Christchurch. Dressing rough and ready to deal with earthquakes of all sizes and that kind of stuff. Again, what exactly was I thinking?!

I arrived at the fashion function with my windswept hair looking like I'd been dragged backwards through a blackberry bush and was immediately accosted by a photographer. This has never happened to me before and the last thing I was expecting was le paparazzi. I thought I was going to look at some suit fabric whilst sipping on a cup of green tea out of fine bone china and nibbling at ridiculously small cucumber sandwiches. I did not realise I was coming out to high society.

Had I known, I would have put on a bit of lippy.

They snapped me standing next to a very glamorous, impeccably dressed, flawless make-up wearing personal stylist. Who I have since been informed is a regular player in the society pages (actually, I was told something a little more along the lines of "she always manages to insert herself into the right photos").

I'm going to blame the IVF drugs for making me look bloated and will hope that my eyes (and the bags under them) weren't too puffy. You know what I mean. The just-crawled-out of bed puffy face look. As is always the case when you would prefer to fly under the radar, I am fully anticipating every New Zealander I have ever met will just happen to look at the paper this weekend and see my photo. And probably a few Australians too.

I don't tend to buy newspapers myself. Mainly because I am the type of person who cannot skim read them and instead spends hours reading through every tiny wee article just to be certain I won't miss something really important. These days I only ever look at a newspaper when I receive a complimentary one in a hotel. Then I feel obliged to read it. I prefer to get most of my news on line, from TV and from talking with people. Might be lazier, but it's much less time-consuming and it spares a few trees. (Please don't mention the carbon footprint of the internet, I have a blind spot where that is concerned).

I suspect that this Sunday however, I may just buy a newspaper.

*****

Swim the Sea

2011-05-15T15:49:00.001+12:00

Live in the sunshine, swim the sea, drink the wild air's salubrity.

Ralph Waldo Emerson

Courtesy of the Telegraph

I commenced my first, and hopefully my only, IVF cycle this week. I am thrilled and excited, but underneath it all I carry the dark dread that only women who have been through this can truly understand. It's not the dread of needles, although I do dread those shiny little sabres. I have found that I can inject into my thigh in the place where my accident* has left an absence of touch. Finally a silver lining to that loss.

No, it's the dread of failure.

What will my body bring forth? How many follicles, how many eggs will I bear? How many will fertilize? How many embryos will survive? Will any?

Am I fertile, or am I not?

At every critical step in this process there is a bottomless pit of cold, dark fear that threatens to break into my consciousness at unpredictable moments. I quiet it. I stomp it down. It holds no profit for me, yet I know it lurks there, in the fabric of my hope and of my dreams.

Some part of me believes that if I do not acknowledge the possibility of failure, that it will not arrive. If I focus on my desired outcome, I will soon have a child in my arms. But, that is how I started this journey, with complete and utter belief in my pending success. Repeated failure serves only to ripen fear and undermine that optimism.

I went to try out acupuncture earlier in the week. I have read the literature, and the evidence for its benefit in fertility is not strong. Despite this, I have been told (by many) that it is very relaxing. I believe in the health merits of relaxation, and so, in order to leave no stone unturned I figured it would be a harmless activity. It wasn't quite what I had expected.

The acupuncturist was working from a medical clinic on the edge of town and it was a bit of a rabbit warren, with the added benefit of incorrect signage that kept me wandering up and down. The receptionist I spoke to was snide and condescending, and for some reason (perhaps because I had gotten out of bed at 3am with a 5.3 magnitude aftershock and was a little tired?), I could not let this go. I kept pressing her to apologize, and she kept growing ever more sarcastic. By the time the acupuncturist collected me from the waiting room I was furious and not feeling all that relaxed. In fact, I burst into tears. Which is quite unlike me.

The acupuncturist was lovely, but the room was sterile with a small window high on one wall through which you could see some cloudy sky. There were bright fluorescent tubes directly overhead. One of the needles must have gone directly into a nerve in my ankle, because it felt like a bee sting and took a while to settle down, leaving behind a bruised sensation. I did not find this at all relaxing (it seemed more like an interrogation chamber, in which I was tortured with nonsense about my splenic qi and TSH levels). The cost for this experience? $135.

I think an aromatherapy spa treatment, with nice music and mood lighting would be more my cup of tea. And more value for money. I cancelled my next appointment the following day, and it gave me a great sense of relaxation in doing so. My qi breathed a sigh of relief.

I have done all that I can to prepare. I am eating well. I am exercising moderately (although this week did kind of go out the window on that front, but I do intend to go swimming again tomorrow). I am listening daily to my Circle+Bloom IVF mind-body relaxation programme.

I feel calm. I feel healthy. I feel strong.

I am still afraid, but I am living in the sunshine, I am swimming the sea, and I am drinking in the wild air's salubrity.

* I haven't written about my accident yet in any detail. It was referred to in Letter to a Friend but as yet I have not had the inclination to explain further. Maybe one day.

*****

A random post

2011-05-07T13:05:00.000+12:00

I have been given some blog awards in recent months, and I admit, I have not followed the rules. At all. Sorry people. In order to assuage my guilty conscience a little, and in keeping with the spirit of the awards, I have decided to post ten random things about me. If you click on the award icons on the left wall, they will link you through to the people who originally awarded them to me.

So, without further ado, some random things about me:

1) I had my first cigarette when I was 6 years old, sitting in a crashed WW2 airplane, in a banana plantation, on a South Pacific Island. It was a rollie.

2) I had my last cigarette in Paris in 1991. It was a Camel.

3) I hate cigarettes. I hate cigarette smoke. I want cigarettes banned. If you are smoking in my presence, or in the vicinity of my presence, you will get a dirty look. And possibly an ahem, a cough or an hysterical asthma performance.

4) I do not have asthma.

5) When I was 18 years old I purchased a one-way ticket from NZ to London. I arrived there with two nights accommodation in a hotel, no job and £1000 to my name. I knew no one in London.

6) I was once held hostage for a night by a knife wielding crazy Irish man. Wrong place, wrong time.

7) I used to speak French fluently. Now, I stumble through the minefield of poor grammar and lost vocabulary.

8) When I was 21, I realised I no longer wanted to be a minimum-waged waitress and decided to become a doctor instead.

9) If I could have three wishes granted, I would definitely ask for a Tardis. If you read my blog you can guess the other two.

10) I don't eat pigs. This probably has more to do with my favourite book as a 9 year old being Animal Farm than my utter distaste for sow stalls.

*****

Letter to a heartbreaker

2011-05-04T10:26:00.003+12:00

I suddenly realised that unless I get a move one, it's not looking good for me completing my 30 Letter Challenge before the end of the year. Being too stubborn to give up, and despite a growing aversion to the topics, here is the next letter. This one is addressed to "the one that broke my heart the hardest" and it wasn't rocket science to figure out who did that.

~~~~~~

Dear T.,

I used to think about you often, but these days it is a rare moment that I find you somewhere in my thoughts, and now I never cry.

We met at work, in the Emergency Department. I had just returned from Melbourne and my hot & steamy affair with M*. I remember clearly the first moment I laid eyes on you. I thought you looked like your brother, and I said "Oh, you must be C's brother". Then I moved on to my next patient, not giving you a second glance, or thought.

I also remember the second time we met. This time I noticed you. I couldn't quite get my thoughts straight as we reviewed an xray together. You were more senior than me due to my years in Europe, but we are the same age. My only awareness was of how close you stood to me. I was lost. Completely. My ten year obsession with M was over.

Work became about seeing you. I celebrated inwardly when I saw we were rostered on the same shifts, and I bit back my disappointment when our paths didn't cross. I enjoyed asking you to help me out with clinical dilemmas, or difficult patients. You seemed to enjoy it too.

One day you asked if anyone wanted to go for drinks after work, and I said yes, count me in. No one else could make it (fate?), so it was just you and I. We went for dinner that night. You told me you were a vegetarian, so when I invited you to my house for dinner a while later, I cooked you a vegetarian curry. It was bloody awful. But you ate it anyway. You had told your mum that you were having dinner with me and I thought this meant something. I found out later that you eat fish and chicken, your first misrepresentation to me.

We started seeing each other. We started sleeping together. You wanted to keep things private and not tell anyone at work. I understood this. I didn't really want everyone knowing our business. But then, I fell in love and I wanted the whole world to know. At least two other doctors were trying to snag you (I didn't count the nurses). It was hard for me to see them flirting with you and not be able to stake my claim. Our secret started to feel like a prison. I started to doubt.

I finished a night shift on my birthday and took you bagels for breakfast. You didn't get me a card. Later at work handover, a colleague had baked me a cake. You were there, you didn't even say "Happy Birthday" to me. I should have seen through to the heart of you. But I didn't.

You were pretty stressed about things when we were together. Your exams; other people's expectations; the flatmate who said she was in love with you. You said you wanted a relationship with me, but then you ended it. Suddenly. Unexpectedly. I was broken into tiny little pieces by the shock wave.

This was the first, and remains the only time I have been madly in love. I didn't realise it then, but I could see things more clearly later, when it was all over. I must have been quite insane. All had been sparkly and luminescent; love songs played on continuous loop in my head; the world was at our feet. I could barely contain my excitement. This type of love is a mental illness. It stops you from seeing clearly, it alters your otherwise rational thought processes, and it causes you to behave in ways that do not reflect your high level of self-respect.

I thought you must have made a mistake. I thought you didn't really mean it, that you were confused about your feelings. I thought you really loved me. I demanded answers.

You told me that you had "tried me on, but I didn't fit". This crushed me. This appalled me. Years later I realised it was a line borrowed from Sleepless in Seattle. You looked genuinely surprised when I reacted badly to it, now I know that this was because you thought you were playing the role of the affable Tom Hanks.

I found it almost impossible to let you go. This was not aided by the way you kept in touch. The last time I saw you was after we danced together at the hospital ball. You had hung around me all night and in the end we danced a couple of slow songs before you ran off, across the dance floor in a very tortured and dramatic fashion. A few days later I went to the hospital photographer's office and explained my story to her colleagues. They let me take the photos of us (and the negatives) so that they wouldn't be up on the notice board.

Now I see that you just wanted to remain "friends" in order to ease your own sense of guilt. It was also important to you that you were perceived as a "nice guy". Either way, it was selfish. I wrote you a letter in the end and I asked you not to contact me again. I thought I would always love you. I really hope you didn't keep that letter.

I was wrong about love. If it's not fed it dies. In time I started to see the things you had said and done in a different light. No longer filtered through the diminished serotonin levels of love. I saw all the ideas, and quotes you had borrowed to make you seem more interesting. I began to wonder what was real, and what was just the image projected onto my life. I started to see your weakness. It took me a year to fully heal. Then, I swept the ashes of our relationship off the porch, and I forgot you.

I saw you last year, for the first time since it ended. Ten years. I knew it had to happen eventually as I had heard through the medical grapevine that you were living in Christchurch now. It's a small community. Thank goodness I didn't bump into you at the local supermarket in my tracksuit pants with my unwashed hair in a ponytail and no make-up...but no, we met at a high class cocktail function and I can only say that I have never felt more glamorous.

I saw you across the room at the same moment you saw me. We smiled and I came over to say hello. We kissed on the cheek. I was genuinely pleased to see you. You look over-joyed to see me. For the first full minute I thought you were your brother! (In my defence, I had already had two glasses of champagne and you do look very much alike. You have also lost a lot of hair since we last met). I was babbling on about a classmate when it dawned on me that it was you. I'm not really sure if you noticed that I mistook your identity, but you know what? I don't care if you did. It makes me laugh, heartily. As far as I am concerned, our unexpected encounter couldn't have gone any better.

So, to wrap up my second and last letter to you, you may have been the person who broke my heart the hardest, and once I loved you with all of that crazy little heart, but I have been a long time whole and when I look back at our brief life together, I am proud of the person I am, the person I was then, and the person I will be. Can you say the same?

Arohanui

* M deserves a post all of his own. Maybe another letter in fact.

*****

The Eligible Bachelor Paradox

2011-05-01T17:39:00.000+12:00

Courtesy of Google Images

As two complete strangers, whom I am unlikely ever to meet, tied the knot on Friday amidst the best tradition, pomp and pageantry the British monarchy could muster, I was absolutely unwilling to peel my eyes off the television screen.

I would never exactly describe myself as a monarchist, but what woman indoctrinated as a child into the magical world of Cinderella and the like, can ever truly disengage herself from a real world fairytale manifestation? Not this woman. I was impressed by the beauty of it all. Or maybe it was simply the display of wealth that impressed me. Either way, I was profoundly impressed.

Basking in the glow of the Royal Wedding extravaganza, I couldn't help but consider my own absentee Prince Charming. Yes, that guy. Mr Right. Mr Knight-on-white-charger. Mr Darcy. Mr Eligible Bachelor. Un jour mon prince viendra...yeah, right!

All this musing about how a 40 year old woman is able to orchestrate her own fairytale romance made me recall an old article I read last year on the shortage of eligible men. The Eligible-Bachelor Paradox by Mark Gimein is an interesting take on the subject of spinsterhood, and I felt it was actually quite insightful.

The premise of his theory is based on mathematical Game Theory (remember the film A Beautiful Mind?) and I have always respected mathematics. The theory is summarized in the following extract:

"You can think of this traditional concept of the search for marriage partners as a kind of an auction. In this auction, some women will be more confident of their prospects, others less so. In game-theory terms, you would call the first group "strong bidders" and the second "weak bidders." Your first thought might be that the "strong bidders"—women who (whether because of looks, social ability, or any other reason) are conventionally deemed more of a catch—would consistently win this kind of auction.

But this is not true. In fact, game theory predicts, and empirical studies of auctions bear out, that auctions will often be won by "weak" bidders, who know that they can be outbid and so bid more aggressively, while the "strong" bidders will hold out for a really great deal.

This is how you come to the Eligible-Bachelor Paradox, which is no longer so paradoxical. The pool of appealing men shrinks as many are married off and taken out of the game, leaving a disproportionate number of men who are notably imperfect (perhaps they are short, socially awkward, underemployed). And at the same time, you get a pool of women weighted toward the attractive, desirable "strong bidders"."

"...it's the women who are confident that they are holding a strong hand who are likely to hold out and wait for the perfect prospect." There is definitely some truth in this, but as with everything human, there are multiple layers of complexity that cannot be encompassed within one elegant theory. We are not logical mathematical equations, and amongst the smug marrieds are some of the most beautiful, intelligent and wonderful women in the world. Some of the strongest bidders if you will.

The problem for me; successful, attractive, intelligent and well grounded (oh, and possibly infertile); is not the lack of understanding of all these spinster theories, or where I went wrong in my romantic pursuits; it is not any indecisiveness on my part or career prioritisation; it is not even a lack of willingness to take on a traditional gender role; it is the simple fact that there are so few (approaching zero?) eligible bachelors remaining in my age group. I have simply missed the boat.

Sitting here on my couch, eating my pistachio gelato, I can't help but think that none of this really matters. Perhaps I should have married young, back in my twenties when I didn't think there was any hurry (and yes, I was holding out for Mr Right). But no amount of personal introspection or self-improvement at this stage in life is going to yield me a larger pool of prospective mates, and the older I get, the less I am inclined to settle for anything other than the "perfect prospect".

Why disrupt a wonderful life for anything less?

*****

Lounge Music

2011-04-22T19:48:00.000+12:00

I'm sitting at Adelaide Airport, in South Australia, listening to a duet singing live lounge music. They oscillate between Dean Martin, The Monkeys, Tom Jones, Elvis, Gerry & The Pacemakers...and even Leonard Cohen (the sacrilege!), and they aren't averse to repeating the same songs over and over. It was a bit of a novelty at first. But now, no matter where I go in this little terminal, there is no escape and I have begun to find it increasingly irritating. I keep having to fight the urge to bang my head against the wall in time with That's Amore. My irritation is compounded a hundred fold when a nearby male decides to start whistling along. I have always found whistling in public to be a rather annoying and selfish act, especially when it's out of tune, but this makes me sound like a grinchy kind of saddo who cannot rejoice in the high spirits of others. Harumph. I suppose I should keep these thoughts to myself rather than scowling at innocent whistling passers-by.

I am easily irritated at the moment. In case you hadn't picked that up. Blame it on fatigue and my two weeks in the desert working round the clock attending to the diseased, wounded and infirm. And infested. This is not a medical blog, and taking into account patient confidentiality I don't intend to write about any details of my time in Coober Pedy except to say...I am not intending to go back. Ever. I shouldn't have gone back for a second visit really. I should have left the memories of my last locum untainted and rather distant. The best part about the last fortnight is that I found series 1 & 2 of Doctor Who on internet TV and had a distraction from the direness of it all.

Coober Pedy Township

The dichotomy between urban and outback Australia will never cease to amaze me. There is a third world country in it's red dusty heart. And a culture there that is very foreign to me. It will be good to get to Sydney tonight. I have another 15 minutes before boarding, then a two hour flight. Just thought I'd touch base on my blog and see if anyone's still reading it after my absence. I'll be back with a proper post soon.

À plus tard!

*****

Oui, c'est moi!

2011-03-30T23:12:00.000+13:00

Oh dear. It has been a long time since I last posted. I think I have been waiting for something to write about that isn't earthquake related. It's not been easy. Clearly. Hence, a quick post to let you know that I am well despite my prolonged absence.

Life is still heavily influenced by the earthquakes here. The central city remains cordoned off, and life is being lived in the burbs. Christchurch is living a half-life amongst the rubble. Many things are normal, many are not. I am uncertain if my house will be repaired or rebuilt, but to be honest, I don't really care either way. Builders are coming next week to do "emergency repairs" and prop up my sagging roof. The beams up there are mostly split and the heavy concrete tiles have caused them to bow under the strain. At least now I can go off to the Outback for April and not have to worry about my roof collapsing whilst I am gone.

I am very much looking forward to my locum in Oz. Crazy huh? Perhaps this is a symptom of PTSD? I usually wouldn't really want to work 24/7 in the middle of the dessert, but after Christchurch, it will be pleasant to be on solid ground again. Although, if you know anything about Coober Pedy, you will realise that it is not a place where you go out for a wander as you may just fall down an old mine shaft and never be seen again. Solid ground is not therefore, guaranteed.

Still no news on my IVF cycle. I may have to leave town for work when I get back from Australia, so I am waiting until I return home in May to decide when, and where, to do my cycle. My fertility diet and lifestyle measures have kinda gone out the window since the quake...ooopps! Not entirely my fault but.

I was watching a show on TV earlier tonight about an Australian lesbian couple who have just had quintuplets. By IUI. How does that happen? I assume clomiphene or FSH stimulation, but still...my clinic would have cancelled the IUI if there had been more than two mature follicles.

The big news in NZ today is that Richie McCaw (captain of the All Blacks) has respectfully turned down his invitation to the Royal Wedding (You may note the capitalization...I am reluctantly capitulating to convention. I am not a monarchist. Sorry). Of course, you may remember young Richie from my crush letter. His decision has raised heated debate over whether or not he has done the right thing (putting his job, rugby, before royal weddings) or has he just been rude? I think almost every female television presenter and reporter in the country has offered to go as his date. Really? This is news?

Oh, and just to give you further insight into NZ culture. Check out our Prime Minister in this tourism advertisement targeted at getting more Aussies to visit Napier. Apparently it was filmed prior to the 22 February earthquake, so I guess he didn't have anything more pressing on his prime ministerial schedule at the time.

Personally, I think he should stick to running the country and give acting a miss. But that's just my opinion.

*****

2 Minutes

2011-03-01T19:31:00.001+13:00

Thanks to all of you for your comments and support. It is a very sad time for the people of Christchurch. Today the country observed two minutes of silence at 12:51pm (one week after the earthquake). I was walking down the street from having picked up my mail (my post office box was accessible today for the first time) when I saw all the staff from my fertility clinic walking out onto the footpath outside the hospital.

I was able to say hi to various staff members and give them a big hug, including one of my nurses. I told her that I was planning to cancel my IVF and get my sperm shipped to Sydney (or somewhere else in Australia) and just do the IVF there. Mr X was there, but he didn't look so evil today. We all stood shoulder to shoulder for the two minutes memorial silence. It was immensely moving. People driving down the road pulled over, got out of their cars and stood quietly by.

This picture is of my local shops (two blocks from my house).

I spent the afternoon ringing patients, organizing medication prescriptions for them and letting them know that our clinic will not be reopening for sometime so they will need to go to other GPs temporarily. One woman, in tears, yelled down the phone "I don't want to see another GP!", in another setting this would be flattering. Here and now, it is just traumatic.

I am working at the hospital tomorrow as a Medical Registrar (?Resident in US). This should be interesting as I don't really know my way around the hospital, but at least I will be doing something. I have a trip organized to Dunedin for a couple of nights to organize my Medical School Reunion for 2012, so I will have a break from Christchurch. It will be nice to have a shower, drinkable water and heating. And not so much dust.

I have decided to stay in Christchurch until I go to my outback locum in April. After that, I will stay in Australia indefinitely and get more work over there. Maybe until the end of the year. One of the doctors at the hospital has already asked if she and her partner can rent my house. We'll see. I'm not sure that it is structurally safe for living in!

*****

Day 5

2011-02-27T01:23:00.002+13:00

I cannot understand how it can already be day 5 or 4dpeq (for the non-IFers that is 4 days post earthquake). The time has gone so quickly and it has all been quite surreal.

People have been asking me what I was doing when the earthquake struck. Well, I was at home eating my lunch and watching Emmerdale Farm on TV. About the least exciting thing one could imagine I suppose! I am not exactly sure how I knew it was not just an ordinary aftershock (we have had several thousand since the September 4th earthquake, so you do get used to them) but I jumped under my table straight away and held on tight to the legs. I wasn't aware of anything other than my grip on a very heavy, oak table that was moving violently in ways it really shouldn't have been. I guess I must have had my eyes closed.

When the worst of the shaking was over and it had settled into a gentle seesaw, I let go of my table and decided to make a run for outside. All around me was chaos. My big bookshelf was lying next to the table on top of all the books and ornaments, things were smashed in the kitchen and every cupboard opened etc. All as you would expect, but I am still surprised that I wasn't aware of the noise and chaos as it was happening. I guess I had my ears closed too.

I got outside pretty quickly and ran around to the front of my house where I watched a sand volcano spring to life. This is when the first big aftershock hit and I did a remarkable impression of a turtle in the middle of my lawn. (This segways nicely to a funny story about when I was walking into the Latimer Square triage centre about an hour later. A large aftershock hit whilst I was between two dangerously unstable buildings. I did the turtle in the middle of the road and no less than four people ran over to me, and stood around me. One lady stood on my hand. My friend thinks that this means either 1) I looked like I had found the safest place, 2) I looked like I knew what I was doing, or 3) I am a shit magnet).

Sand Volcano

Anyway, back to my lawn. What I hadn't realised about liquefaction and sand volcanoes, is exactly how much water is created. Out of nowhere I suddenly had a gushing fountain of water on my back lawn. Now, this is a film I took with my iPhone. Unlike Peter Jackson, I kind of suck at making movies so if you watch it please excuse the lack of editing.

The streets were flooding with water. My yard was flooding. I initially thought that my water pipes had broken (even though I knew it was the wrong area of my yard for this to be the case) so I turned off my water mains, and a couple of other mains for neighbours. This of course made absolutely no difference because the water was not from our pipes, it was from "thin air" or more accurately from "thin earth". Crazy. I turned off my gas and power mains as well.

Once I had done this I changed out of my work clothes into cargo pants and jumped in my car to drive to the main 24 hour clinic on the edge of the CBD. This was a mistake as the roads were congested with cars and very damaged (with no power for traffic lights). When I got there, there were plenty of doctors and not that many patients so I decided to walk into the centre of town where my own clinic is. This is how I ended up at the main emergency triage centre, and I stayed there for the rest of the day.

Buildings I know well were in ruins all around Latimer Square and the CTV building was putting out so much smoke we had to wear masks for a large part of the afternoon. There were a lot of people in the north end of the grassy Latimer Square, sitting around in shock. My practice nurse (who was on a day off) cycled in and helped out with minor patients. She was amazing. I was so very impressed by her efficiency and calmness. We managed to get into our clinic to grab tetanus shots and dressing packs etc, so she was busy administering all this.

I met up with an old medical classmate (now an emergency physician) at the triage centre, who was in town for a course (which had incidentally, been held in the Hotel Grand Chancellor that is now on such a lean it has stymied search & rescue efforts in the surrounding two blocks). They had managed to escape by breaking down a door. I found it very comforting to have her company, even with the fact that she was 22 weeks pregnant (and yes, I saw her rubbing her belly). She did an awesome resuscitation with a haemothorax in the triage tent. Such a star.

I was at the triage centre until just after midnight when I was sent home for some sleep. I didn't get much though, too much adrenaline and too many aftershocks. I slept in a makeshift bed under my dining table.

The next morning, the triage centre had been handed over to military control, so I contacted some army friends and managed to get permission to go in and assist. This time I cycled my road bike in. There wasn't a lot happening at that time as the last living person had been extricated from the CTV building at around 3:30am. He remains the last CTV survivor. It is thought that there may be up to 100 people still in the ruins. Including the GPs I mentioned in my last post and at least one of my patients. The owner of The Clinic has released a statement that of the 16 clinic staff, 13 remain in the ruins. Only a few of their names have so far been released (presumed deceased). The irony is that The Clinic for many years was just down the road from our practice. They moved into the CTV building after the September 4th earthquake when their clinic had become unsafe and was cordoned off. That building still stands today.

I went with an army ambulance through the city to the North Hagley Park Welfare centre to help write scripts for tourists who had left all their medicines in hotel rooms as they made their desperate escapes from the CBD. The trip through the city showed me just how much devastation there was. It was absolutely heart breaking.

Towards the end of the day the army pulled out of town to hand over to the search & rescue teams, and to go back to their camp and get organised for the makeshift morgue that has been constructed out there. I caught a lift with them to the Pyne Gould Guinness building and was pleased to hear a woman had just been pulled out alive. That was about 3:30pm on Wednesday. She remains the last survivor recovered from the Tuesday earthquake.

I spent the evening catching up with family and friends by phone and watching the news coverage. People overseas have told me that they have seen me on TV. Well, yes. If you saw the early coverage you may have seen me too...without realising it of course ;) I recognize many of the people in the television coverage.

The next morning I got water back on at my house. It has to be boiled for 3 minutes before drinking, but it enabled me to have a bucket bath and wash my manky hair. The water smelled of the smoke from the CTV building and ran dark with the dust of my city's ruins. It felt invigorating to be clean again.

I spent a bit of time phoning around contacts to organize work on Thursday morning. Eventually I was given the ok to go into the USAR camp (Urban Search & Rescue). Latimer Square had transformed overnight into a tent village, fenced off, with teams from Australia, Japan, the US and elsewhere. I took my boss with me and we were escorted into our clinic to retrieve medical supplies and equipment to set up a medical clinic at one of the welfare centres. It was all very time consuming. The Welfare centre we ended up at was in a poor area of ChCh and was very demoralising. It was closed the following day due to health & safety concerns and the people staying there were transferred out to a better facility in the country. An Australian field hospital has now been set up at the same site.

I left the welfare centre just after 9pm and went straight to J's where her husband cooked me dinner and poured a glass of wine (yes Elphaba, I have broken my egg-enhancing alcohol abstinence). It was lovely to be looked after and although I didn't sleep much that night, I was in a very comfortable bed!!

I took yesterday "off" for a rest day and to clean up my own mess. Which is not quite as bad as I had initially thought, but I have cracks in my foundations and some of the brick work. Windows won't open and doors won't close. All ceilings and floors need repairs. Not too much got broken considering the amount of things that were thrown about the rooms. My childhood china doll (no, I am not one of those women who likes dolls. This is just a sentimental keepsake from 9 year old me), was found unharmed underneath a heavy bookcase.

One example of many

Today, my practice nurse, her fiancé and a young American tourist (an EMT who helped us on Tuesday at the triage centre and is now staying at my nurse's home) came over to help dig up my liquefaction. Here are the before (actually halfway) and after shots.

Things have quietened down a bit now, and I am not sure what to do next. 70% of GP practices in the suburbs opened yesterday, so many patients were able to be attended to in primary care. The after hours surgeries are steady but not too busy and there is an abundance of doctors rostered on to these clinics. My clinic will not be opening again in the foreseeable future. Although it isn't too badly damaged (rummaging through it for supplies in the dark was an experience though!), the buildings around will need to come down, the roads are extremely damaged, and no traffic will be allowed into the CBD for quite some time. It will be months (if ever) before my practice opens again.

Tomorrow I will have a think about what I can do to help further. Thank you everyone for all your kind messages of support, here and on Twitter. Yesterday was the day when the fatigue set in and brought with it an immense sadness. There are wonderful stories of survival and the heroic acts of everyday people. There are also the horrific stories of loss that I don't even want to think about.

The support we have received from nations around the world has been so wonderful, and so greatly appreciated by all New Zealanders. It brings tears to our eyes and chokes us up when we hear of all the international well wishes and contributions of equipment, people and money.

Thank you all.

Arohanui xx

Death toll 145. Still rising.

*****

These Little Earthquakes...

2011-02-23T19:48:00.002+13:00

Just a quick update. I am exhausted. I got home shortly after midnight last night in an attempt to get some sleep in case needed again through the night. I think I finally fell asleep about 5am, but it was interrupted frequently by aftershocks and by 7.30am I was wide awake again.

It was a surreal experience at the triage centre yesterday. The air thick with smoke from fires in the collapsed CTV building. Helicopters overhead with pontoons. I seemed to know almost everyone. Doctors from around the country (none from ChCh), army nurses and medics that I have previously worked with, the deputy mayor and others. A classmate from medical school (now an Emergency Physician in another town) was a great comfort to have close.

The civilian trauma triage centre handed over to the army this morning so I tracked down some of my military friends and organised to assist the green team. I decided to cycle to Latimer Square due to the police/army cordons and broken roads. It's hard work cycling on liquefaction. One of the buildings that is opposite my practice is a backpackers hostel. Some of the staff are patients of mine. It won't be reopening.

I know for certain that at least one of my patients is dead. Buried in the CTV building along with others. I am still hoping that The Clinic medical centre staff were able to get out unharmed. I have heard nothing of them. I am very sad to say, that there was no joy to be had and the rescue efforts in the CTV building adjacent to us were abandoned this afternoon.

I spent some time today at the North Hagley community welfare centre. Displaced tourists unable to get into their hotels to take their medications. Some with medications not available in NZ. Some too distressed to even remember what they take.

Just before I finally jumped on my bike to cycle home, a woman was successfully extricated from the Pyne Gould Guinness building a couple of blocks away. It was here I sat with another woman waiting for news on her sister trapped inside the building. She had just been informed that there were no heat temperature signatures detected in the rubble. We have not yet given up hope.

So, now I am home again. The triage centre is gone and the medics have left to concentrate on services elsewhere. Tomorrow I will look at volunteering at one of the local GP walk in clinics. Tonight, I have people to call, texts and emails to return. Thank you all for your words of support and messages.

Arohanui xx

*****

Update on earthquake

2011-02-22T22:30:00.001+13:00

Hi everyone. I am ok. My house is badly damaged but I'll worry about that later. I have spent the day at the emergency triage centre in the city centre. Still here on my iPhone. They are still digging people out of rubble. Many dead. It has been awful. The city was on fire most of the afternoon but this evening the rain came down with a vengeance. People are cold and in shock. I am lucky to be surrounded by colleagues and so grateful to be alive! I have GP friends who were in one of the collapsed buildings. They are not here and I keep waiting to see one on a stretcher. So much devastation. I'll update again when I can.

Thanks to all of you for your kind wishes and support xxx

I come, leave we...

2011-02-21T17:38:00.000+13:00

Hello. If you are visiting my blog for the first time today due to ICLW then welcome! I guess you will be expecting to read an infertility blog? If you have already checked out the About Me tab you will know that this is my Happiness Project, and although I write a lot about infertility (because my failure to have a baby has been one of the most important roadblocks to my overall happiness), it is only one of the topics I write about here.

When I got the reminder from Stirrup Queens that ICLW was starting tomorrow (actually, today for me as I am a day ahead of most of you), I realised that I couldn't let my last satirical post be your first introduction to me. Read it if you like, but keep in mind that I do not actually own a Ginsu knife and I am a totally non-violent person who would never resort to that kind of craziness in real life (I chase flies out of my house rather than kill them for goodness sake!). Just so we're clear :)

I am going to provide you with a cheat-sheet link guide to my main infertility-related posts for getting the low down on my IF journey if you're interested. Yes, I am single and I am also 40. Not a great place to start when you're trying to conceive...

This first post is the Scooby Doo wrap-up of my first 8 IUIs
My final IUI (#9)
My subsequent desolation
My options for moving forward
Reflections on my year of failure
My new 2011 theme (Get Busy Living!)
What I am currently doing to improve my egg quality (if this is even possible?)

My IVF will start in May 2011 when I get back from a short stint in the Australian Outback. Despite my innate fear of failure, I can hardly wait!

If you are still reading and expect to return here again, my next post may not be on infertility. It may be a continuation of The Paris Chronicles, or a social commentary on feminism and the eligible bachelor paradox, or it may be on something entirely different. I can't tell yet. But you are welcome to drop by again to find out.

Arohanui xx

*****

Breaking News

2011-02-18T10:28:00.001+13:00

Elphaba over at Yolk has been writing this week about Facebook pregnancy announcements and the emotions they tend to invoke in Infertiles. You should check these posts out for a chuckle if you haven't already.

Her planned post for tomorrow is on how to announce your infertility on Facebook. I was writing a comment for her which became so longwinded and totally out-of-control, that I decided to just post it here instead and link back to her.

So, without further explanation, this is how I intend to announce my infertility on Facebook...

*****

Breaking news.

A 40 year old female doctor was today tasered in a Christchurch fertility clinic.

Witnesses say a crazed looking woman entered the building at approximately 11:08am carrying a Ginsu kitchen knife. She then proceeded to take Reproductive Endocrinologist Mr X hostage in one of the clinic's surgical theatres.

It is not yet known what prompted the attack. Reports from an undisclosed source suggest that the woman had a personal grievance with Mr X relating to bedside manner and vaginal speculums. A witness report that the woman was carrying a canister of frozen sperm under her arm has not yet been substantiated.

Mr X, a 48 year old father of two and well respected fertility doctor, was freed when the Armed Offenders Squad arrived and managed to subdue the woman with multiple taser shots. Mr X was not injured in the attack.

Fertility clinic staff confirm that the woman, local GP Dr A, was known to the clinic but refuse to comment further.

Questions are now being raised as to the safety of doctors working in fertility medicine. An industry known to be frequented by highly emotionally charged women. A spokesman from the Sensible Sentencing Trust, Russell Brown, said that despite mild alarm over the multiple tasering of Dr A, this type of "societal breakdown" must not be tolerated. "We cannot have infertile women running around making demands with Ginsu knives" stated Mr Brown.

Work colleagues of the accused released the following statement this afternoon "We are all deeply shocked and distressed by the events earlier today. Dr A is well liked and respected by both staff and patients. She seemed so normal. We weren't even aware that she was infertile. Our thoughts go out to Mr X and his family. We genuinely hope that Dr A will now receive the help she so desperately needs."

Dr A is recovering at Christchurch Hospital where she will undergo a psychiatric evaluation. The police have declined to comment citing an ongoing investigation into the matter.

*****

What about me?

2011-02-16T11:25:00.001+13:00

Valentine's Day has hit NZ in a big way this year. The 6 o'clock news ran stories on florists stocking up for the big day (and charging obscene prices for a single red rose that doesn't even have a scent). I was asked by coworkers (about 5 times) if anyone had sent me flowers, chocolates or a card. Nope. None of them got anything either. And they are all married. But, apparently, to "absolutely bloody useless" men (Direct quote from various sources and not necessarily the view of the author. Oh, and best read with a Kiwi* accent).

I don't know. It's difficult for me to get all fired up about a day that celebrates only those who have found love. Don't they get enough of life's pie already? I preferred it when Kiwis disparaged it as some cheesey American custom. Now it appears that it has been embraced and subsumed into the my own people's culture. Now it is in my face.

A day for the smug marrieds, and the smug lovers to waltz around with beautiful flowers and yummy looking chocolates. Possibly sparkly things as well. And sexy lingerie...

It brings to mind that old Aussie song by Moving Pictures "What about me? It isn't fair, I've had enough, now I want my share..."

[Actually, you should check out the video which is a bit of an antipodean blast from the past. This corner dairy could easily have been filmed in NZ with it's blackball lollies and Walls Icecream. Oh, and Alex Smith pronounces "can't" like a Kiwi not an Aussie...]

To be honest, as much as I hate to admit it, I am just jealous. Jealous of the smug marrieds. Jealous of the smug lovers. Jealous of the smug fertiles. I want my share of flowers, chocolates and sparkly blood diamonds. I want my share of babies.

Yesterday, was not the best day for me. I didn't sleep well due to being woken up every 30min by pain (long story). I then had a visit from my heavily pregnant cousin which made me feel barren, broken and hopelessly infertile. I felt quite sorry for myself. As if Valentine's Day, with it's reminder of my perpetual singleton status, hadn't been enough of a smack in the face already. My day was overcast and dreary. Then I collected my mail.

An incredibly generous and kind-hearted Marie at Bakery Closed Until Further Notice, had taken it upon herself to send me delicious chocolates (and a card) for Valentine's Day! This parcel had travelled all the way from San Diego to Christchurch in 3 days just to arrive in my hour of need. I can't tell you how stoked I was (because I am in a hurry to get off to work), but my cloudy day melted away into insignificance and I remembered that life is not all that bad really. That I quite enjoy being me (I'm a cool chick when I'm not being a dick). That I don't need a diamond on my finger to be happy (although not too keen on longterm celibacy). And that I still have baby opportunities in my future.

Thanks Marie! For making me smile and for filling my bloodstream with chocolate endorphins.

*For those of you who keep commenting on this. A "Kiwi" is either a flightless bird that is native to NZ, or a colloquial term for a person who is native to NZ. It is not a fruit. What you are thinking of is the "Kiwifruit" which is originally from China (when I was a kid we called them Chinese Gooseberries) but Kiwis were better at marketing and distribution, hence the name change.

*****

Letter to a Stranger

2011-02-13T14:12:00.001+13:00

Right. I have made an executive decision. I am changing the order of the letters in my 30 letter challenge. I am still considering binning the entire project, as I have already lost interest (and really, it's all a bit boring)...but, I guess that is all part of the challenge? Anyway, as rules are made to be broken, I have decided to write the letters in any random order of my choosing. It's my blog after all, and I make the rules here.

*****

Dear Adam,

I have been intending to write to you for some time now. Ever since that day back in November when I received confirmation that you had accepted my friend request on Facebook.

I cannot begin to describe my amazement that a) I sent you a friend request in the first place, and b) that you accepted it.

I do not accept friend requests from strangers myself. I also do not accept friend requests from people who can't be bothered writing a brief salutation. But, perhaps you intend to use Facebook for your fans and therefore don't require any formal introduction or ritual greeting?

I have never before sent a Facebook friend request to a complete stranger. Now, I find myself in this unfamiliar situation where I feel a need to justify my actions. And to point out that I am not a stalker. Well, not really.

I have experienced two stalkers in my life (excluding the three men who followed me at various times through the streets of Paris and tried to force their way into my apartment. They don't quite meet my stalker criteria as they had only a fleeting image of who I am). The first lasted between the ages of 18y until about 21y, and consisted of frequent long letters (each at least 30 pages) from a distant relative who quoted biblical scripture interlaced with personally threatening psycho-erotic fantasy. Even in the years before I became a doctor, I realised there was something seriously wrong with his mind.

The second stalker was more recent, and he was the spawn of Facebook. This chap, who had known me in primary school, used false pretenses to track down my mobile number (he called a mutual acquaintance in Australia and fed her a story about medical emergencies). He also managed to acquire my personal email address (damn it Google!). He telephoned me to tell me that he had enjoyed holding my hand at primary school, that we were once boyfriend & girlfriend (sheer fantasy), and that he had been recently concerned about a sore on his penis that turned out to be an ingrown hair... He also exhibited some poorly-masked rage towards his ex-girlfriend. Hmmm.

The immediate consequence of this Facebook stalker event, is that I culled my friend list and put all but my personal friends (and you, because I felt a bit rude cutting you lose after I had only just requested your friendship) onto the most limited privacy viewing options. The downstream result of this has been that I have lost my taste for Facebook and rarely visit it's shores these days. You will no longer find anything of interest written by me there and I have removed almost all of my photos.

The other direct consequence is that this, my new blog, is written under a pseudonym.

So, you may be wondering how I came to find myself in this role of something-a-little-bit-like-a-stalker given my clear aversion to those of that ilk? Et voilà, the reason for my letter. To explain the sequence of events that led me to intrude randomly into your Facebook world.

The inescapable truth is that I have been for some time now, a big fan of your father. A while back, someone mentioned that you too were in the business and I discovered that I also enjoyed your work.

One evening early last November, after being completely mesmerised by your father, my cousin and I had a conversation about you. With the assistance of a bottle of fine New Zealand Sauvignon Blanc, we googled you and discovered that you had a Facebook profile. The decision to hit "send friend request" was not very well thought out. I didn't expect you to accept it, and I didn't anticipate the unsettling sense of being a stalker that it would seed in me. I have found it quite impossible to write on your wall or comment on your posts.

That's it then. A simple explanation. One you perhaps did not require, but now my conscience is clear and I have pled my case in the court of stalkerdom.

Finally, I would just like to add, somewhat belatedly I know. Hello, kia ora, et salut! I'm very pleased to have made your (virtual) acquaintance.

Arohanui

*****

Eggs on Toast

2011-02-06T18:38:00.003+13:00

I'm taking a break from my Paris memoirs to talk about fertility. Again. One of my favourite topics. Warning, this post gets a little science-nerd-amongst-the-pigeons at times.

I have been very excited the last couple of days because my cycle this month was 26 days. Before I began all this "single mother by choice" malarkey, my cycles were pretty regular and usually 26 days (sometimes 27/28). Never less. Somewhere amidst all the angst and psychodrama of my repeated IUI failures, my cycle shortened to 23 days. And stayed there. This was not a good sign.

Short cycles are widely regarded as being a problem. They probably represent a crap luteal phase (otherwise known as Luteal Phase Defect), but they may also represent poor egg quality. At least, that's what my reading has so far suggested. [Disclaimer: I'm no fertility expert]. The luteal phase should be between 12-14 days long, anything less than 10 days and you are unlikely to get pregnant. (Longer cycles don't appear to be much of a problem though). LPD may be due to insufficient progesterone, but there are many factors at play here and everything in the reproductive cycle is inter-dependent, so the root cause is not easy to identify. In order to have a normal luteal phase, you need to have a normal follicular phase first.

MissX the fertility specialist told me that emotional "stress" will normally lengthen the menstrual cycle through delayed ovulation. My subsequent reading seems to back her up on this one. But I was pretty convinced that my heightened stress (largely due in fact to the fertility clinic's poor management) was the cause of my shortened cycles. I may be right, I may be wrong. Studies that look at the effects of emotional stress on LPD are quite difficult to find, but there is definitely some evidence that stress may reduce fertility overall.

In my case, there were confounding factors. Firstly, somewhere amidst all my IUI treatments I simply stopped exercising. It began with my very first IUI. I had a mini-triathlon scheduled for the weekend that I was likely to ovulate, so I canned it. That was the slippery slope to couchpotato-hood. There was always a reason that I didn't want to go for a run, in case of over-heating, or too much impact (that may jiggle the embryo loose), or just because I was mopping up the tears of devastation after yet another failure.

Secondly, I started to eat a very poor diet. I attribute this to my stress levels. When I got home from work I just couldn't be bothered cooking, or I couldn't be bothered going to the supermarket to buy groceries, or I craved carbohydrates (chocolate and other lollies) to ease the pain of infertility. I started to find that my diet consisted largely of toast. Beans on toast, tinned salmon on toast, vegemite & cheese on toast, scrambled eggs on toast (oh, the irony), toast on toast...you get the picture. At least I used Vogel's bread (Sunflower & Barley). But still, if you are what you eat, I was a piece of toast. Lately I have come to realise that this diet meant that my eggs were also toast.

Now for some science. There are things in our bodies that cause oxidation (like when a banana goes brown or a car rusts). These are called pro-oxidants or free radicals. Then there are things that keep oxidation in check by mopping up excess free radicals. These are called antioxidants. A healthy body is one that has these chemicals in perfect harmony. When your body gets out of balance and you have too many free radicals, you get oxidative stress. This is not a good thing. Oxidative stress can play a role at every physiological step of the reproductive process. Oxidative stress can lead to luteal regression (ie. shorter luteal phases. Ah ha!). It can damage the oocyte (developing egg) and the embryo, and impair implantation.

The developing egg needs to be fed the right nutrients prior to ovulation so that it has the energy it requires to sprout a well-rounded embryo after fertilisation. It also doesn't need to be stressed out by oxidation. High levels of free radicals have been shown to be detrimental to egg quality. The follicular fluid micro-environment therefore has a critical role in determining the quality of the egg.

To reduce oxidative stress, you either have to reduce the free radicals (pro-oxidants) or increase the antioxidants. This is where the science gets controversial and unclear. It seems like eating more antioxidants is the right thing to do. Right?? Sadly, there is a lack of consensus on the type and the amount of antioxidants to take and clinical evidence (so far) for their benefit in infertility is equivocal. There just haven't been enough powerful studies to know for sure. So who knows?

Are antioxidants harmful? Well, maybe. If taken in very high doses, some of them can cause problems. Here we come back to the harmony aspect of our bodies. Everything should be in balance. You can get antioxidants in supplement tablets (vitamin C, selenium, vitamin E etc), or you can just eat the healthy foods that contain them. This is my preference. If you are eating a balanced diet, then you are unlikely to reach excessively high doses of antioxidants.

Which foods contain antioxidants? Well, pretty much any fruit or vegetable that is red or blue is a good place to start. This list will give you some ideas. I am having lots of berries and green tea daily to scavenge up any over-abundance of free radicals.

Other foods that may be fertility friendly (although don't ask me to supply references) include:

Broccoli
Spinach (& all dark leafy vegetables)
Salmon
Pumpkin seeds
Sesame seeds
Ginger
Turmeric
Spirulina

One of the fertility food websites I visited suggested that some foods to avoid include peas & soy. Soy definitely makes sense to me as it contains phytoestrogens which presumably can muck up our natural hormones.

So, back to me. What have I changed to get back to my 26 day cycles (and hopefully better quality eggs)? I have started this blog (my happiness project) and I no longer feel stressed about my infertility. I haven't cried since my last failed IUI. I have started regular exercise again. I am stuffing my face with nutritious food (including antioxidants). I am no longer drinking any alcohol, and my caffeine is limited to one cup of instant coffee per day. I am still working on reducing my sugar which appears to be bad for just about everything...

I think that's about it.

*****

The Parisian Chronicles pt.2

2011-02-02T10:31:00.002+13:00

Following my restful sojourn à côté La Tour Eiffel, I crossed the Seine and moved to the 8th arrondissement. I took a position as a child minder for a 7 year old boy two days per week in exchange for a room in an upper class apartment building on Boulevard de Courcelles. The family was very nice, the father was some type of doctor and they had a teenage daughter who was a real sweetie. They were of course, extremely wealthy.

Boulevard de Courcelles

At my interview I was asked if I could swim, so I said yes, that in fact I had even done a swim lifesaving course (I think this cinched the deal). Of course, my basic lifesaving course had been when I was ten years old and I hadn't been in a pool for many years, so when I took the little boy swimming I tried to avoid the deep end. Fortunately, he was not able to swim very well himself so it was easy to stay in the shallows and I was never challenged to do any rescuing. (Although I do have one slightly unpleasant memory of dog paddling around trying not to drown. I don't think anyone noticed though).

We often walked down to Parc Monceau where he would ride his bike or play soccer with the neighbourhood kids. Sometimes I would have to be goalie. I would always have to push his bike home. It was exhausting, but I enjoyed these days in the park.

Parc Monceau. Courtesy of Google Images

As some of you will know, many of the old stone apartment buildings in central Paris have six or seven floors. The top floor is where the servants would be housed back in the day, and they would access their employer's apartment by a stairwell at the back of the building. This is where my room was found. It was a tiny room with a built-in wardrobe, a single bed, a sash window, a chair, a small table, a sink and a benchtop electric cooking element. There was no fridge so I used to keep my milk standing in cold water in the sink. Fortunately, it was now winter in Paris and my room never got warm enough to sour milk.

I had no bathroom. My employers had said when I took the position that I could use their bathroom to shower. However, they gave me no key to their apartment and I think I was able to use their shower once the entire time I lived there.

There was a toilet down the hall that was shared with all the other servants (none of whom I ever encountered, though I sometimes heard footsteps down the long, unlit corridor). The toilet was a Turkish toilet. My new employers had not shown it to me when I was being interviewed and the first time I saw it, I believe I cried. For those of you who don't know what I am talking about...

This is a clean version...

Before leaving Avenue de la Bourdonnais (my address next to the Eiffel Tower), I had acquired a job at McDonalds on the Champs Élysées. Given my experience with flipping Macs back in NZ and my English language skills I was placed on the front desk. Many of the customers spoke English and even though my French was embryonic, it wasn't too hard to understand a request for "Un Big Mac avec des frites et un Coke." The universal language of Micky D. When language failed, there were always pictures to point to. (Actually, the best McDonalds I ever ate at was the Moscow one shortly after it opened in 1990. But, that's another story).

Photo courtesy of Bloomberg Businessweek

So while I minded a little boy two days a week I continued to work here, but only for a month. It wasn't the happy, smiling workplace I remembered from my teenage years. And besides, I got a better offer.

My new job was as a room service waitress at the Marriot Prince de Galles hotel. It was an American-owned hotel on Avenue Georges V, just off the Champs Élysées. It was next door to the Georges V hotel and all the embassies. I saw it once featured in the film French Kiss. The job was fulltime and for the first month they allowed me to have days off that coincided with my child minding. After that, I would have to make other arrangements.

In France they pay your salary monthly. This means you have to work for a month before they organise to pay you the first installment. You could only get a bank account with a letter of recommendation and proof of employment. Anyway. I had no money. For a long time I lived on Nutella and French baguettes. What I learned from this diet, is that this particular combination is the most constipating substance that one can ingest. Limestone is not the only way to make cement. I didn't really mind not having to use the toilet too often though...

Side Note: For many years following this I physically gagged whenever I saw Nutella on supermarket shelves. I can eat it again now, but I am always careful not to have too much in order to avoid concrete stools.

Courtesy of http://cafefernando.com

The Christmas of 1990 was not all that I hoped it would be; huddled in my 6th floor icebox. My decision to leave Boulevard de Courcelles was made easy. My employers went on holiday. The toilet became blocked and so foul, I am not even going to begin to put it into words. Even now, sitting in my lounge 20 years later, I still shudder at the thought of it. It's one thing to encounter these types of toilets when you are passing through a third world country or tramping in the middle of nowhere. But when it's a few metres down the hall from your bedroom. Non, merci.

This was in the days before email and mobile phones. There was no way to contact my employers. So, after a couple of months of working 7 days per week; living off cigarettes, coffee and Nutella; wearing shoes to the toilet; showering at work (or doing the sink sponge-bath), and sleeping fully dressed to keep warm (it was now snowing in Paris). I wrote my employers a short (somewhat accusatory if I'm to be honest) note that informed them I could no longer tolerate the toilet and I was too traumatised to remain until they returned from their ski trip. I did feel a touch of remorse about not saying goodbye to the little boy who had come to love me. But, c'est la vie. I'm sure he survived the loss.

I left the letter with the building concierge before moving out, and moving on.

*****

The Parisian Chronicles pt.1

2011-01-30T23:27:00.001+13:00

Shortly after my 20th birthday, having little or no money in my purse, and nothing particular to interest me in London, I decided to move to Paris. I had been working in London pubs on and off for about a year, as so many kiwis have done before and after me, and I had only been to Paris once (to go to a Prince concert). It seemed far more alluring than London.

I travelled to France via a budget airline that went to an airport in the middle of nowhere and then provided buses into Paris that arrived in the city sometime after 11pm. I had travelled with a few girls I knew from the pub where I worked and we had met a couple of young men at the airport. None of us had anywhere to stay that night, so we sat outside an all-night cafe on the Champs Elysées and sucked in the ambience. And the Marlborough Lights.

In the early hours of the morning our new Scottish acquaintance reported that the French gentleman he had been talking with had offered us a bed for the night at his home. It seemed improbable. But the next minute, 7 young people and their backpacks were piled onto a small convertible and driven to what can only be described as a mansion. Next door to the Eiffel tower.

I became vaguely concerned when the French gentleman informed us that he didn't have his key to the gate and asked one of the guys to climb over the high wrought iron gates to let us into the courtyard...but I figured I would see how things played out. When in Rome...etc. He then produced keys to the house so we all cautiously followed him in. It proved to be his own home ( I was not completely convinced of this until his teenage daughter woke up and came down from her loft to say hello) and we were not just dumb tourist accessories to an imminent crime.

The house was four stories and filled with incredibly opulent furniture and artwork. It was magnificent. Through the window, the Eiffel Tower stood emblazoned in the night sky, with one of it's legs appearing to land in our host's backyard (his garden gate opened onto the Champ de Mars adjacent to the tower). Wow. This was a long way from the dodgy end of Wandsworth.

A memorable sojourn, viewed from top of Eiffel Tower.

As things so often transpire in my life, an opportunity presented itself and I came to live in this house for three months. Ostensibly as a "child minder" for his 12 year old daughter. I only had some early high school French and therefore no ability to actually speak the language. This became a slight barrier as my young ward did not speak English. I went to Alliance Française and gradually improved my French, but to be honest, I don't really remember seeing her all that often.

While I lived in the mansion next to the Eiffel Tower, I lived in a secret room. On the third floor. It was accessed through a false wall in the back of a closet in the stairwell. It had a small ensuite and kitchenette, and a little window that peered down onto the courtyard below. I thought it was trés cool. But I was only 20. I sometimes wondered just who may have hidden in this room throughout the years.

At one time I got quite sick. I remember walking home from the metro and having to stop and vomit into a rubbish bin in front of the Eiffel Tower. Passers-by eyed me up as potentially unclean and avoided me. After a couple of feverish days, my employer took me to a doctor who worked in a very expensive looking office a few blocks away near Les Invalides (I have often compared my own career as a GP to this French GP, and I have fallen short on both the unbridled wealth, and the prestige front). This is when I learned that the French preferred to use thermometers rectally...sadly I had not been made aware of this fact in the days leading up to the doctors visit, when I had been using my employer's thermometer orally.

I remember walking the family's two little dogs around the Champ de Mars in the late summer evenings (no, I did not carry a pooper-scooper or equivalent. I don't think they had been invented yet). American tourists would stop me to pet the dogs and ask me their names. I would reply in broken English and pretend to come from somewhere exotic (like Czechoslovakia, which was where my employer's wife came from). I'm not sure why I didn't just admit to being from New Zealand which is way more exotic, being on the opposite side of the globe from France and therefore further away than Timbuktu. But I didn't realise that the real me was exotic. Back then.

I borrowed some sneakers (they were those old fashioned white tennis shoes) and started to go for runs around the park. I wasn't very fit, and I didn't run far. One evening I was prancing around thinking how chic and French I appeared to all the tourists (you know, being a local and all), when I came a-cropper on my conceit. I leaped over a chain fence at the back of the Eiffel Tower, sailing gracefully through the air. And the toe of my shoe (which was a little too big for me) caught on it. I landed face down in the gravel. With tourists everywhere. Leaping to my feet, face purple and with blood dripping down my knees, I exclaimed ça va, ça va!! Ha, ha! No, didn't hurt a bit! Pas du tout!! And scampered off home (in pain) to lick my wounds. I never went running in Paris again.

I really liked my employer. He was an incredibly charming, generous and intelligent 72 year old. (Yes, he had a 12 year old daughter. With his current and fourth wife who was about 40). He accepted me without prejudice or judgement. He didn't mind when I gobbled up all the escargots (this is a story that to this day still mortifies me. So I'm not going to tell it to you). He didn't mind that I didn't really do anything in terms of my employment. He didn't mind that my education of the world; of philosophy, politics and current affairs; was woefully absent. I could tell you lots of stories about him. He was an exceptionally interesting man who used to play the stock market (and was once arrested for undermining the economy of a South American country). He was particularly intrigued by my story...which he felt must have had something about it to be intrigued by. The intrigues of life are all relative to one's perspective.

I have missed this man, and one of my life's regrets is my failure to keep in touch with him.

Sadly. There was of course, very little child minding to do for an independent 12 year old, so in due course I moved on. On, to a new room hidden from view. But one that held far less romance.

*****

The Crush Letter

2011-01-23T22:48:00.002+13:00

This 30 letter challenge is much harder than it appears at first glance. In my weaker moments I have contemplated removing all references to it from my blog and hoping that no one notices. What? A 30 letter challenge? No, you must be thinking about someone else's blog. No forensic trace. Plausible deniability.

Foolishly, I push on. I'm only up to letter number two and I'm stuck again. This one is addressed to "your crush". Who to choose? There is no one in my real life who has had that description for several years, and I can't really remember what it felt like to be totally besotted with a bloke. I am therefore reduced to writing to one of my many fantasy crushes...but an entire letter to Colin Firth? How dull. The following letter, is a greatest hits compilation to a few of the crushes that come to mind, it is by no means complete. Forgive me.

*****

To: all the boys I've loved before, who travelled in and out my door, I'm glad they came along...

Courtesy of Google Images

Mr Firth. May I call you Colin? Actually, I would prefer to call you Darcy, and so I shall. Since the moment you strode across the grounds at Pemberley, in your wet shirt following your impromptu swim in that rather weedy-looking pond (I'm not sure that I'd have been able to keep my eyes open in that dirty looking water, and thank goodness you didn't become entangled in those reeds and drown...), I, like so many other women across the globe, have been utterly and incontrovertibly under your spell.

In vain have I struggled Darcy. It will not do. My feelings will not be repressed. You must allow me to tell you how ardently I admire and love you. In such cases as this, it is, I believe, the established mode to express a sense of obligation for the sentiments avowed, however unequally they may be returned. I eagerly await your reply.

Courtesy of Google Images

Alexander Skarsgård, how do I love thee? Let me count the ways. Or better yet, shall I compare thee to a summer's day? Thou art hot. Very hot. Sometime too hot the eye of heaven shines, but not too hot to melt the Iceman of Generation Kill. Although maybe Eric Northman would disintegrate with the sun's first kiss? I can assure you that not from any kiss of mine.
I'll protect you from the sun, you can protect me from the hooded claw. Keep vampires from my door etc, etc. Ditch that Bosworth chick. I just know that your mother would like me.

Courtesy of Google Images

Ok, so I know you aren't the real Joe DuBois, you are just a television character and your real name is Jake Weber. Based on a real person maybe, but there is no way that the real Joe DuBois could be anywhere near as wonderful as you are. You are without question, the perfect husband.
You are always supportive, caring, intelligent, a great dad, a bit dawky (this is good because it reduces the chances of another woman stealing you away), you like physics, and I cannot believe how patient you are when Alison is constantly waking you up in the middle of the night with her bloody dreams. You never seem to get angry with her. You have the patience of a saint. Saint Joe. I would marry you. But you would have to get a haircut first.

Courtesy of Google Images

You may not remember me Richie McCaw, but we met once. We live not so far apart from each other and when I saw you at the local supermarket I said hello. Just to be friendly like. You looked terrified. I would have thought you were used to strangers saying hello to you, especially in Canterbury, home of the Crusaders. But then I realised...it was 2009, the year of the cougar, and I may have had that predatory glint in my eye. What can I say? I'm sorry I frightened you young man.

With love,
Arohanui

Here lies Arohanui

2011-01-20T19:47:00.000+13:00

OK. So I have been MIA from my blog for the last week. I know you have all really missed me (if you have actually noted my absence at all, that is). The reason for this extended absenteeism? It is entirely related to my last post and is the fault of my new maxim to "get busy living" (GBL).

I have been busy. Busy trying to live life to the fullest and pack in all the wonderful things that I want to be doing. I have, of course, encountered a wee problem here. A problem with over-ambitious scheduling and my erroneous belief that I am a highly skilled multi-tasker. It appears I am not. I have been so busy doing everything else, that I haven't left enough time to write in my blog.

There are a few activities which appear to be detrimental to my quest for GBL perfection. One is the time I spend on Twitter (reading tweets to catch up on what has happened overnight on the flip side of the globe, rather than actually tweeting myself), and another is the time I spend reading other people's blogs. Which I love. But, I spend a lot of time reading them. I have decided that there has been too much inefficiency and opportunity cost here. I need a new game plan.

What's the root cause of my failure to multi-task effectively? Discipline. I have none. Well, that is not entirely true. I can be very disciplined when I have a plan, a goal or just to be stubborn. But most of the time, I lack it. I am also easily distracted. Usually by pretty or shiny things in shops, but also it seems, by links on websites. I have previously mentioned my inability to delay gratification when it comes to things like watching TV. Well, I also have the inability to delay gratification when it comes to internet surfing and online social networking. Twitter has supplanted Facebook in my affections, which is good, but replacing one addiction for another? Not so good.

I read something recently on another blog (I can't remember which one sorry) about the online bios used on social networking sites, and whether, if you were gone tomorrow (i.e. Dead) you would be happy to be defined by your bio.

I thought about this for all of two seconds and realised that, hell no!!, my Twitter bio is not how I want to be defined! Or remembered. I promptly changed it.

This was my old twitter bio: "I am forty, single, childless...I have a successful career in medicine and business, but I can't help but think that I didn't get the right life advice when I was a girl."

Ugh. What was I thinking? Not a lot evidently. I do not want to be defined by my age, my marital status or my lack of children. I am so much more than all these things. I don't want my headstone to read "Here lies Arohanui*, she was a barren spinster who watched a lot of TV".

This is my new bio: "Doctor. MBA. Blog writer. Traveller. Lover of cats and fine bicycles. Dreaming of Motherhood. And of Paris. Just a child, pleased with the sound of my own name ♬"

(The musical note was to link to my username without having to explain that, no, as much as I would like to, I do not play the violin. Unless you count the world's smallest violin, which I am very adept at).

Now, it's not all that easy to portray a comprehensive summary of who you are in 140 characters. This will do for now, and I reserve the right to update, upgrade and embellish as often as it interests me to do so.

I was commenting to a friend on my last post how easy it is to be distracted by the meaningless and let the days glide by without paying them enough attention. This is not how I want to live my life. I am paying a lot more attention to "the days" these days.

My days.

They are too precious to be ignored.

*I definitely do not want my Pseudonym to be on my headstone!

*****

A New Maxim

2011-01-13T10:53:00.000+13:00

By now many of you will know that I have chosen my 2011 maxim or theme. I have decided to hold on fast to "get busy living" because it is exactly what I need right now, after my groundhog-day year of fertility disappointments, and it has a great consonance with my personal commandments (see list on left wall).

So far things have been going very well. I have been getting busy! Too busy in fact to spend a lot of time writing in my blog, so I have decided to identify the elements of my "living" that I want to nurture over the coming year. In order to do this I have set up a task list on my iPhone that includes writing in my blog, reading a book, engaging in a social activity, doing something creative or cultural, learning something for work (the journals keep piling up), pampering myself, and lots of sports training (running, cycling and swimming). Each week I am required to tick off every item on the list to keep myself accountable to my priorities.

Do I need to point out that this list represents my minimum weekly activities and is by no means the bounds of my living? It is a simplistic way that I can ensure I have attributed my time well on a day-to-day basis, and in a way that makes me happy (I gain pleasure from crossing out items on a list), but it is not prescriptive and life should be full of unexpected surprises and opportunities. These are the things that make you feel truly alive.

As you may have noticed, I have taken on some blog challenges for the year. First, the 30 Letter Challenge for which I must write a list of letters in the order specified. And second, the Reading Challenge which requires me to read more books for pleasure this year than I did last year. I have set a pretty low target on this one (12 books) so that I can assess my baseline without unrealistic expectations. You can see what I am currently reading on my Goodreads bookshelf to the left and I will add a very brief review to my reading challenge page when I am finished.

I have reviewed my list of goals for the year. Some of the goals from last year, that gathered dust under my fridge magnets, have now been resurrected. My priorities have not changed so drastically that my previous unattained goals have obsolesced, instead they have been refined and sculpted into something a little more current. You can check out my list of 2011 goals here.

Today, as I write this post, I am happily munching on strawberries from my garden. I am made even happier by the knowledge that I have thwarted those pesky birds by constructing a chickenwire cover that stops them from getting at my berries and eating them before I do.

It's a good day. I am a smug strawberry eater.

*****

A letter to a friend

2011-01-10T19:06:00.001+13:00

This is the first letter of my 30 letter challenge. To be honest, I really struggled with this and wanted desperately to change the letter order so that I could write something easier. Something funny and entertaining. I don't have a specific person to whom I would apply the label of "best friend". The person I am closest to is probably one of my cousins. I see her only about once a year because we live in different cities, but we talk on the phone weekly. I spend a lot of my time with my good friend J, and there are several other friends who mean a lot to me but many of them also live in other cities.

In the event, I have chosen to write to G, a person who some believe to be my best friend. To write about all the things that sometimes go through my head when I lie awake in bed at night. The things I have never been able to say to her.

*****

Dear G,

You are my oldest friend. We have been friends for more than 26 years; more than half our lives. When we were at school I worshipped you. I remember approaching you the day you arrived from that other school and asking if you'd mind if I called you "G", you didn't. I thought you were beautiful, and cool. We used to go running together at Newtown park. After we had finished running we would buy chocolate flakes to eat, or sunbathe topless on the grassy bank. We often left it too late for me to catch the bus & train home, so I would stay the night at your place. We would listen to our Duran Duran and Wham singles as we fell asleep. I didn't like going home.

You taught me how to use eyeliner, and we never went anywhere without wearing it. You introduced me to my first (short lived) boyfriend. You gave me my first cigarette, my first alcoholic drink and my first joint. We used to push your mother's car down the driveway after she had gone to bed and drive around town meeting boys. Your mother thought I was a bad influence.

We met your first husband at a Blue Light Disco when we were 14y. I gave him your phone number and you were really mad at me. You got married when I was living in France, and I found out when I phoned you a few months later. You said you didn't ask me to be a bridesmaid (or invite me to the wedding) because you didn't think I would fly back from Europe. I would have.

For many years, you repeatedly lamented that I should have been your maid of honour. What could I say? Yes, you should have asked me to be.

When your husband had an affair, you asked me to fly up from University to support you. I had a lot of exams to study for and I had very little money, but you said "I need you" so I dropped everything and I was there for you. You took him back despite his long history of cheating. I didn't like this, but I supported your decision. I never told you that he once made a pass at me.

When you eventually divorced him, you went a little wild. You drank a lot and partied with your workmates. I worried about you. I didn't like the person you became when you drank.

When you got engaged to your second husband, you invited me over to show me the ring, and to tell me that your two half-sisters (who you hardly knew) were going to be your only bridesmaids. They were flying in from overseas for the occasion. You never acknowledged that I may have been disappointed not to have been asked. You asked me instead to read a poem at your wedding. I read the poem. I read it well. I learned it off by heart and I didn't stop even when that car drove into the side of the church. I looked at you often while I spoke. You didn't look at me once. You fiddled with your bouquet and looked bored.

You have a big picture collage of all the people who were at your wedding up on your wall. I am in one of the photos. Your children all think that another woman, in several of the other photos, is me. I don't know who she is.

All of your family, and your husband's family, know me as your best friend. Your four children call me Aunty. You tell them that this is special, that "Aunty" is only for family. You tell me often that we are like sisters. I wanted to be a Godmother to one of your children, but you never asked me.

You rarely phone me, and if you do it is usually because you want some medical advice. You say this is because it is a toll call, even though it costs only $2 to talk for 2 hours. If you do phone me, you ask me to call you back because I pay for unlimited tolls. One time you forgot to do this and when you got the phone bill you complained bitterly to me that "we" had forgotten to put the call on my account. You sometimes text me, but when I reply you don't often respond.

When I had my accident I text you from the hospital. You replied, but didn't text me again until one night when you were out drinking with friends. You said you loved me and that you were only saying this because you were drunk. Those were the only texts I got from you. I was in hospital for one month. Other people sent me flowers. Other people text me daily. Other people telephoned me. J managed all of this from London.

It was a very tough time for me. It was the loneliest time of my life. I learned who I could rely on. Even more difficult than being in hospital, was trying to manage alone at home the first few months with a physical disability. You don't know that I had to use a frame to walk with; you didn't see the skin on my wasted legs hanging over my knees like sackcloth; you don't know that it was almost three months before I had my first precious moment without pain.

When you were having some problems with anxiety, your husband contacted me for advice. I helped as much as I could. I invited you to stay with me for a break. You came and we had a great time. You said to me "I should have come down when you were in hospital". Yes, you should have, but I said nothing.

I was telling your sister-in-law a while back that all I had ever wanted was to have a family and be a mum. You were surprised and told me that you never knew that about me. You never asked. Or maybe you never listened?

When I saw you six months ago I thought I was pregnant, you were excited for me. But I wasn't pregnant. You haven't asked about my attempts to conceive since then. If I was pregnant now I don't think I would phone to tell you.

You have known me for 26y, but you don't know who I am. You don't know that I write this blog, you don't know what takes place in my life, and you don't know what is important to me.

I don't fully understand why I have never been able to say any of these things to you. Our lives are tied together by the most delicate of thread. You think we are like sisters, but I see that our relationship is so brittle it could disintegrate with the slightest sign of dissension.

We are friends, old friends. But, we are not sisters.

Arohanui

*****

On Dating

2011-01-05T13:54:00.000+13:00

New Zealand does not have a dating culture. We do not date here. If you go out on a date with a stranger, no one is entirely certain of what the etiquette should be. Men do not pay, either because they don't want to give offence by insulting a woman's financial independence, or because they are too cheap. Women do not want to have the man pay (but let's face it, they really do) in case it creates an obligation of some description. What we Kiwis know about dating has been learned from watching American television, and I'm not too certain how realistic "How I met your Mother" is. To date more than one person at a time (or more than one consecutively inside any given week) is considered distasteful and would result in the label of "player" (for a man) or "slapper" (for a woman).

How do we then meet members of the opposite sex? Don't ask me. Clearly I have no idea.

I have just spent the last hour trawling through men's profiles on an on-line dating site that I am toying with signing up to. I haven't. Signed up, that is. Yet.

You can't read someone's entire profile until you do sign up, so I was just looking at all the photos and their truncated wee blurbs. It never ceases to amaze me what men consider an appropriate photo to put on these sites. You have one shot at making that first impression. One shot. A blink of the eye, if you subscribe to Malcolm Gladwell's point of view. Do you really think that a facial close-up taken by your laptop in skype-like quality is going to cut the mustard? Or that one of you in your tracky dacks and stained t-shirt with your hair tousled and greasy? Is it entirely congruous to say in your blurb "always laughing" when your photo looks downright angry? I think not.

So men. Why not smile? Or at least, if you don't think you look good smiling (please note: everyone looks more attractive when they smile), try not to frown. Or grimace. Perhaps you have read that women are drawn to the dark and brooding protagonist? You think you look sexy when you frown? Get a second opinion. Preferably from a woman, and before you decide to post your photo.

I think there could be a business opportunity for a savvy woman out there to wash, dress, hairbrush and then photograph these men. I'm not talking about a complete make-over where the end result is misrepresentative of the actual man. Just a "put your best foot forward" scenario, where the man actually looks clean, would be an improvement.

Many could use a hand with writing their profiles as well. Spellcheck would be a good start. The number of profiles that state that the subject is definately very inteligent leave me cold. Ok, so perhaps they are a highly intelligent dyslexic? Perhaps. However, I suspect that an intelligent man would be aware of how his first impression may be received, and would know how to use spellcheck.

I know that I shouldn't be a literacy snob, but it really does trouble me to come across poor spelling and grammar. If you are reading this blog then you will be well aware that my grammar is not perfect. I often start sentences with conjunctives for goodness sake. Quelle horreur! I do not claim to be a queen of the English language, far from it, but I do respect language. And if someone's grammar actually offends me, then it must be truly horrendous.

While scanning the current offerings on this site, I recognised one of the men as a young guy I had stitched up New Year's day about five years ago after he had fallen through a plate glass window in a drunken NYE stupor. I recognised the round scar on his forehead where he'd required a skin graft. I also recognised some of the other men on the site. 2 degrees of separation. That's all there is here in NZ. It's a real deterrent to going on-line to discretely seek your romantic connection. Knowing that half of your friends, patients and professional acquaintances will see you there.

I had a brief interlude with this site about two years ago. When I say brief, I mean it lasted for two weeks. I was so overwhelmed with messages from unsuitable suitors that I just couldn't bear it any longer than that. Some of the men asking me out were 20 years older than me. I prefer younger men, and yes, I had a specified age range. Men just seem to ignore these things in a "she'll make an exception for me because I am so amazing" type of mentality. Few appeared to have read my profile (I had written that good spelling was important to me) and I suspect that they just liked the look of me. Further evidence of the first blink impression.

Despite my intense discomfort with the site, I did in fact meet two men and go on some dates. The first guy I met was a real sweetie. He was young, Sri Lankan, lived in the wop-wops with a menagerie of animals (no, I didn't see this first hand), can't remember what his job was, and he was a little shy. There was no chemistry but we went on a couple of dates just to be polite.

The second man I dated was a clinical psychology masters student. In his profile he professed to being extremely good at communication. I went on two dates with him as well. There probably wouldn't have been a second date but we had wine with dinner the first night and I got a bit tiddly (wine goggles, and he did have lovely eyes). He was interesting. In a scary kind of way. His idea of good communication was to interrogate me all night asking intense, inappropriate and deeply personal questions. I suspect he was unable to separate his career from his private life. Sadly, as I became acutely aware, he neglected to actually listen to my answers (and therein lies the disparity between the student of clinical psych and the practitioner).

He arrived late to dinner for our second date, and he did not apologize for keeping me waiting (strike 1). This is where I'll mention that he was a little man, short and petite. I'd say he weighed a good 10kg less than me, and I'm pretty slim. He had little lady hands (strike 2, I just can't help it. Lady hands!). I made a concerted effort to ask some questions of my own this time. His only hobby/interest was playing war games with toy soldiers (strike 3). I told him I imagined him hanging out with a bunch of middle-aged paedophiles in David Bain jerseys. We both laughed at that, but I wasn't really joking.

After the date I sent him a very nice and polite email to say "thanks, but no thanks, we do not share enough in common". He responded with a long and arrogant email suggesting that I reframe my beliefs and convictions to match his own (which were clearly superior). It only served to reinforce my decision that he was not the man for me. Weirdo.

This dating took place, as previously stated, almost two years ago. During 2009 I lived by the maxim that I would not turn down any social invitation, including blind date suggestions, no matter how unappealing they might be. I had another two blind dates that year, set up with the help of friends. One of them drove rally cars and hunted pigs in the weekends (if you know me at all you will realise the dichotomy here). Neither of them sparked.

Four dates, early in 2009, are therefore the most recent engagement I have had with any active hunt for Mr Right. By the end of 2009 I had already entered my babychase phase, and dating was no longer a priority. In fact, it was eschewed in favour of cycle monitoring, frozen sperm and cervical catheterisation. Now that I am on sabbatical from the fertility game, my thoughts are leaning back towards seeking Mr Right. But can I be bothered? I guess that's something to explore in another post.

*****

Old Champagne & Christmas Cake

2010-12-31T23:17:00.001+13:00

This entire holiday season has been one of last minute realisations. The focus of my mind held elsewhere in the weeks leading up to it. Perhaps I should have organised a holiday away? Perhaps I should have sussed out a good party for tonight? Perhaps I should have picked up some shifts at the emergency clinic? All reasonable things to have planned. I however, did not plan.

I thought I would be pregnant. I am not. Back-up plans are not routinely the domain of the optimist. Something good is expected to just pop up.

It's 10pm on New Years Eve and I am sitting in bed with my laptop. Great. I neglected to organise something to do tonight, so instead I have been watching really bad reality TV (High School Musical 3 was on the other channel. Blurgh!) and finishing off the open bottle of champagne I brought home from my Christmas Eve work do. It still fizzes and is surprisingly good.

I only receive 3 television channels (4, if I jiggle the rabbit ears on my bedroom 14 inch (circa 1984)). This channel paucity is pretty much by design (with a wee bit of procrastination involved). I worry that if I get more I will spend all of my time watching TV and never actually get any real world living done. Don't even mention Tivo to me. Deadly.

I do not have an addictive personality (disclaiming chocolate, handbags and sparkly items), but television is my vice. It has a way of luring me in and before I know it I am hooked. If I ever get a TV season of something good on dvd, I will watch the episodes back-to-back until I finish it, only pausing for food, water and toilet breaks. When it comes to TV, I cannot delay gratification.

In my early days at Medical School I was known as "the walking TV guide". I should perhaps be telling you that I was busy partying or studying or romancing or something else in keeping with student life, but no, I watched TV. Even a couple of years ago in a quiz night I was still unbeatable at rapidly identifying theme tunes to old shows. I'm not proud of this. (Well I am actually, it's always nice to be a winner!).

I used to tell my friends that I got my medical degree by watching ER. Don't worry, it's not true (although it was helpful). At some point in time my study, my work, my life took a higher priority than my TV watching. I am now a recovering telly-addict. As with any addiction, a relapse is a constant threat and so, I keep to the 3 free analogue NZ channels. I apprehensively await 2013 when I will be forced to go digital and enter a whole new world of temptation.

Oh, I got distracted by the fireworks and it is now 11pm. One more hour to suck the life out of 2010. Hmmm. What to do? Eat another piece of Christmas cake? One last glass of champers?

I might just go see what's on TV... ;-P

*****

Earthquake Preparedness

2010-12-28T14:51:00.000+13:00

If you weren't already well aware of this fact, at 4.35am on September 4th 2010 a 7.1 magnitude earthquake struck Canterbury, New Zealand. Unlike the 7.0 Mw Haiti earthquake, no one died.

Many houses were damaged. Brick buildings were reduced to rubble as their mortar turned to dust.

Roads were cracked and uneven.

People stepped out of their homes in the black of night and sank into pools of liquefaction. Sand volcanoes erupted in backyards.

Our earth was broken.

Our city was scarred. Majestic buildings with gaping holes, incongruous like giant missing teeth.

A previously unknown fault line was revealed where it ripped across the Greendale landscape.

It was a diminishing event. Mother nature taking you by the throat and shaking the living crap out of you. Convincing you that your number was almost up; another few seconds and the sky would most certainly fall in.

On September 4th, for 40 seconds, 400,000 Cantabrians were confronted with their own mortality. This is something that resonates with you long after the threat has receded. Of course, having more than 4000 aftershocks doesn't help with the moving on.

Aside from our first world building codes, and some truly miraculous near-misses, the reason no life was lost is largely due to timing. At 4.35am the bars were closed and most people were tucked up safe in their beds. Not walking the inner city streets where they may have had bricks raining down on them.

The downside of this is that we were wrenched from our deep sleep by a terrifying chaos. Power was knocked out so our homes were pitch black. We were thrust into an unfamiliar and formidable world that didn't begin to feel safe again until the sun rose and reclaimed its hold.

Daylight. That is all it took for me to feel that I could handle whatever came next. A false sense of security instilled in me by the fact that I could now see my world. And what a world. It was a beautiful Saturday, the sun gifting us with its full might to drive away the cold and fearful darkness.

The most common complaint from my patients (following the initial "motion sickness" and "imbalance" presentations in the first two weeks of acclimatizing to a ground that moved frequently beneath your feet) has been insomnia. For some reason the big aftershocks seem to come mostly during the night and interrupted sleep does no one any good.

For the most part, I haven't thought much about the earthquake in many weeks. By day four after the 7.1 Mw, and after 3 nights of sleeping fully dressed with my iPhone in my pocket and survival getaway kit next to my bed; leaping out of bed to take shelter every couple of hours; I made a conscious decision to stop worrying about another big aftershock and just get on with life as normal. My adrenals were depleted and I no longer had the energy for the heightened environmental awareness that follows such an intimidating event.

I don't often notice the aftershocks anymore; the little ones are no more than the impression made by a strong gust of wind or a heavy truck passing by. Things have been pretty quiet recently. Until Boxing Day, that is.

I stayed at a friends on Christmas night and was abruptly awakened a little after 2am by a 4.2 Mw aftershock. This doesn't sound very big, and compared to a 7.1 Mw it is not, but an interesting thing about earthquakes is that when they are very shallow and you are sitting on the epicentre, even the 4's can give your house, and your nerves, a good shake-up. This was the first of 17 aftershocks for the day, with a 4.9 Mw knocking out power again and bringing down more inner city buildings. The Boxing Day sales were a bust.

I went for a run this morning and saw a car crushed by a chimney, a collapsed roof, cracked stone walls and yet more fresh wounds inflicted on my neighbourhood.

So, with earthquakes back on my mind, I thought I'd share with you some earthquake preparedness tips.

1. Learn about earthquakes (or other disasters) before they happen
2. Keep a torch by your bed
3. Make a plan for what you will do when disaster strikes
4. Maintain a survival kit

Lastly, I want to point out that Haiti, with all its loss of life, destruction and subsequent disease ravaging its people, is still experiencing aftershocks too. Spare a prayer for those poor souls who have not been so fortunate as we have here in Canterbury.

(All photos courtesy of Google Images)

*****

Getting Busy

2010-12-22T10:47:00.001+13:00

I started writing a post about Christmas, but after writing a few paragraphs I realised that it was a bit of a grinchy whinge, and I am tired of whingeing. It's all I seem to do these days. The last year has been so consumed with fertility treatments and trying to conceive, that with each subsequent failure I have become more and more of a complainer.

I am now stepping off that rat wheel for a while. I don't know what this means for me exactly, but it is the path that has presented itself. So I am taking it. I am taking that journey back to my Self that I spoke of when I started this blog and of which I was reminded yesterday when reading Marie's greeting card post.

As I have pointed out before, this blog is my happiness project. It is my tool to recapture the happiness I had, not so very long ago. Inability to conceive has the tendency to kick happiness in the guts and bury it's decaying corpse under a pile of hormonally heightened emotions. I have strayed off my course and I want my happiness back. I demand it be returned to me. It is mine, after all.

I watched a Shawshank Redemption rerun the other night, and all day yesterday Tim Robbins' "get busy living, or get busy dying" resonated throughout my thoughts. Have I been busy living this year? I'm not sure that I have. I have been busy trying to create a new life, which is unashamedly my raison d'être, but have I really been living my own?

So much has been put on hold this year. My sport, my work, my lackadaisical hunt for Mr Right. All left neglected in the shadows as I became completely mesmerised by the brilliance of my fertility dream. Transfixed by the image of my future baby. An alternating sequence of hope and despair.

My list of goals for 2010 remains on my fridge where it has been all year, obscured by magnets so long that the targets have all but been forgotten. Apart from the one relating to climate change, I have achieved none of them. This is new. I always achieve my written goals. I always get things done. The lack of goal attainment is just one more illustration of this fruitless year.

Have I been getting busy living or just letting my life whiz on by, without the attention and investment it deserves? I'm not sure I really want to have an answer to that question. What I do want, is to get busy living. Now.

So what's the plan? IVF in May? Possibly, probably, that's a decision for another year. Today I stopped taking folic acid.

I intend to undertake a formal inquiry into 2010 and the failure to meet it's deliverables. I have decided a component of this audit will be to identify a list of stellar achievements that have taken place, and write a retroactive list of targets based on these. That way I will salvage something from 2010 to be proud of. It will make me feel better to see a list of accomplishments for the year rather than a list of unattained goals (it's not cheating, businesses do this all the time!).

I will write a new list of personal goals for 2011. Maybe I'll share them with you all so that I can then be held accountable... I am also looking into selecting a theme word as suggested by Gretchen Rubin over at The Happiness Project. I am leaning towards "smile", but I also like "sing". The theme that I eventually settle on is going to align with my list of personal commandments (see list on left wall) so that I can continue to incorporate these into my daily life.

My new austerity measures have been put in place (I am not allowed in or near the vicinity of Andrea Moore or Country Road) and I am turning my attention back towards my sport. I love my road bike, but it has been sorely neglected and it's time to show it some loving again. Today I am going to go for my first run in at least 6 months (in a minute) and I remember something that Gretchen Rubin once said about "put on your shoes and close the door behind you". Easy.

Last night there was a total lunar eclipse, the full moon glowed in the night sky and lit up the clouds with a magical luminance. It reminded me of my place in this vast and beautiful universe.

It is a gorgeous, hot and sunny day here today. The norwester wind is pretty gusty (will have to try and catch a tailwind for my run), but it's pretty perfect really. I have an awesome life.

Time to get busy living it!

*****

The Phantom

2010-12-17T13:02:00.000+13:00

I am not pregnant, 3 BFNs can confirm this, but I'm not sure that my body has accepted it. CD31 and AF is finally here but she lacks any sort of commitment. My breasts are still under the influence of progesterone. I have been queasy on and off for days and almost got carsick driving myself to work on Wednesday. I gagged twice yesterday, once at a patient's smell (I was discrete) and once at the smell of my organic recycling bin. I don't usually have a very good sense of smell. It's not like me to gag during activities of daily living (kind of useful for my line of work too).

Increasingly I begin to suspect that I am experiencing a phantom pregnancy.

In the last two years of cycle monitoring I have never gone beyond CD28 (it's usually 26 days), so I think that I may have had an early implantation pregnancy (or chemical pregnancy if you prefer), but my embryo arrested growth, or lost it's foothold, or something. Perhaps I should have had that CD28 beta so that I would know definitively if implantation had occurred, but it's too late now so I must make do with speculation and uncertainty.

Regardless, I am going to have to nip this pseudocyesis crap in the bud as I am not inclined to collaborate.

In breaking news, I have been kindly awarded a "Cherry on Top" from Moon over at Moon On A Stick. Awesome. Please go and check out her lovely blog.

There are some rules that come with this award:

The rules: link back to the person who gave you the award, pass it on to five (or a bunch of) other blogs, and leave them a comment telling them of the award.

So I have had to think about who to pass this on to. Clearly Moon already has one, and so it seems does Yolk (another of my favourites), so I have come up with another five deserving blogs that I follow and enjoy and gain inspiration from. They are:

Bakery Closed Until Further Notice

Single Infertile Female: Now What?

Sarah Fain Has Starfish Envy

Chasing Rainbows

Stork Stalking

I suspect that anyone who reads my blog will already know these wonderful writers, but if you haven't yet visited them now's the time to drop by.

*****

Options

2010-12-14T11:55:00.000+13:00

Thanks to everyone for their lovely comments and tweets after my last post. I am much better now. Saturday was my day for grieving and feeling the hurt; Sunday was for my Colin Firth marathon (BBC's Pride & Prejudice - the best adaptation ever made); Monday saw my reemergence into the world (3 depressed patients in my afternoon clinic! Yes, I ran late), and today the sun is shining and I am doing just fine.

It's CD28 and still no AF. Still spotting. Still BFN. I spoke to the clinic nurse this morning (she called to see if I needed a βHCG), she was lovely and suggested if no AF by Friday (CD31) then I should probably do a beta just to make sure. I am without hope that the two HPTs I have done were false negatives. I am not pregnant. I will just wait.

She has offered a January IVF booking. Short cycle, so I could potentially be entering the 2nd trimester during my outback locum in April (if the IVF worked that is). This would mean rushing around to organise medications just in case CD1 in January arrived before the clinic reopens after the holidays. It may mean morning sickness whilst on call 24/7 as the only doctor in a 400km (-ish) radius. It would also mean an air retrieval if any pregnancy-related problems occurred during my locum.

It could be done. But it sounds stressful, and stress is the last thing I want. So, I have said no. I will wait until the New Year to make a decision about my next step.

My options include:

1) Waiting until May to do a relaxed short-cycle IVF
pro: Cycle would be managed by my trusted friend SW who will be back from the UK
con: My eggs will be 6 months older

2) Canceling my Aussie outback locum in April
pro: Can start IVF in February
cons: Cycle managed by MrX; no money from locum to pay for IVF

3) Buying a round-the-world ticket and having an adventure
pro: Yay! Exciting adventure!
con: No baby

4) Move to Alaska in search of husband
pro: Marry hunky man who will father my children (ok, still IF barrier)
con: Very cold in Alaska

On Sunday night a friend called to organise a coffee catch-up for tonight. I told her about my current IUI's failure to launch, and that it had been my last IUI. She said "it's always when you stop trying and relax that these things happen". She meant well (she's a psychiatrist for heaven's sake!), but I pointed out that the lack of sperm in the equation may be the rate limiting factor. We both laughed at this. It seemed very funny at the time.

See, even we single women get the "relax it will happen" advice about baby making. I've received this advice for years with respect to finding a husband also. It hasn't worked there either. I can almost guarantee that relaxing and doing nothing is not the best life advice. In fact, the entire "it will happen when you least expect it" school of wisdom is utterly, and incontrovertibly flawed. It either happens or it doesn't and your expectations are quite irrelevant to the outcome. Your actions however, are another story. They are very material to the outcome.

Despite this rather negative sounding diatribe on the influence of our expectations, I do believe that the actions we take in our life can bring us the rewards we seek. I am an optimist (seems a little incongruous I know) so I do expect good things to happen, but I also know that if I want specific good things to happen, then I must take specific actions to bring them about.

I am hopeful about the future and thoroughly expect to have all the things I want...eventually. And, if not exactly what I want, then I am likely to reconfigure my views on what it is, exactly, that I want.

*****

Proven Otherwise

2010-12-11T15:46:00.002+13:00

I woke up very happy today. Very happy indeed. The first thing I did on waking was check to see that my boobs were still swollen. Yep. Still progesterone in my veins. All good. Off to the toilet and all good there. CD25 and I haven't been beyond CD23 in quite sometime. Feeling confident. Smiling away to myself. PUPO.

Such a glorious day here today. The sun is just beaming and it's almost too hot to be outside. I am watching a couple of the neighbourhood birds balancing on the flax flowers outside my bedroom window. It's all just perfect.

Well, it was perfect. Until about two hours ago.

It's all over. PNP. Proven to be NOT Pregnant. Again.

I was on my way to meet my friend of convenience to hear her apology. I nipped to the toilet before leaving and had all my hopes crushed. I kept thinking to myself, maybe it's just implantation bleeding? Maybe, there is still hope? I don't think I really believed this. My hands were shaking. My body knew it was over.

I went anyway to meet FoC (any similarity to that 4 letter word is entirely intentional). I painted on a smile and tried to keep my mind in the denial phase of grieving for just a little longer. It was exactly what I had expected. She was really sorry for being "sharp"etc with me, but it was all my fault. It was in fact because she found my FERTILITY issues just a little "too intense". The truth is, I have only ever talked to her about my fertility problems when she has enquired about how things were going. I cried on her shoulder once. The day I found out that I would inevitably miscarry IUI#2. She knows less about my journey than anyone reading this blog would know.

So that's the apology. A slap in the face half an hour after I had discovered that my final IUI attempt had failed. This was a little too much to take. We have "discontinued" the friendship.

I cried a lot in the car on the way home. I cried a lot when I got home.

I did a home pregnancy test just in case. Just in case it was only implantation bleeding. I'm still crying.

I have that dull ache in my chest that feels like it must be my heart breaking, what else could it be? But I know in actual fact it is just oesophageal spasm from crying too much. Something ordinary. Nothing extraordinary like a heart splitting in two from the sheer disappointment of a lost possibility.

I know this loss doesn't begin to compare to a lost baby, or a miscarriage. It's no different from anyone else's disappointment over their own failure to conceive. It's just another disappointment. No more, no less.

But, it hurts.

I am waiting for J to call so that I can cry in her telephone ear.

*****

Commandments

2010-12-09T21:17:00.014+13:00

I'm feeling stressed. And anxious. I was doing ok with this 2ww until this afternoon. Suddenly I have too much to do, too many unpleasant tasks pending completion. And I am annoyed. I received a christmas card from someone I truly dislike; who shouldn't know where I live; who addressed it to "Miss" even though they know it's "Dr" (trust me, not an oversight, definite passive aggression); who didn't put a return address on the card so that I could return-to-sender...but what really upset me, was just how much it upset me. I could feel my heart pumping away with adrenaline, and all I could think about was that adrenaline is not ideal for implanting blastocysts.

Stay calm. It's one of my personal commandments (that are now a bit hard to read as I changed my blog formatting and can't work out how to change the list's font colour). Let it go. That's another commandment. But it's so much harder than I'd like it to be. I tried to distract myself by reading blogs and catching up on tweets, but my mind keeps wandering back to the offending card. And I really don't want it to. So, instead, I am writing it into a post in the hope that I'll leave the bad feelings out there in cyberspace. How completely ridiculous that one little thing like this could cause such an unwanted physical response. This is the only person alive that could make me feel so bad, just by sending a card.

Stupid, stupid waste of emotions. I have been trying so hard to make IUI#9 a perfect attempt. One last try with everything optimised. CD23 today, no sign of AF. Was feeling like this may be the one. Now, just feeling stressed. What if my over-reaction to a little piece of cardboard has jeopardised my chances of conceiving?

I have a coffee date with my "friend of convenience" on Saturday. She text me to say that she would like to apologise to me and have a chat. To be honest, I am a bit anxious that it will turn into a "I'm sorry, but it's all your fault" type of apology. I realise that this is overly pessimistic, but Saturday will be CD25 and if AF has not arrived, I do not want any stress. Perhaps I should have put her off, but at the time it seemed like a good idea, and in keeping with my do it now commandment. I have a bad habit of putting off the things I just don't want to do. Like having difficult conversations with people, or telephoning large companies to sort out a consumer issue...I know that I always feel better once the task has been completed, and it is never as bad as I anticipate, but still, I practice avoidance.

My work christmas party is tomorrow. It's a mystery bus tour with a Japanese theme. Each year the practice owners go to a lot of trouble to make it a big surprise event for everyone. This year I have said I am not going. I just don't want to go. Either I will be PUPO and close to the end of my 2ww, or I may be getting hints that AF is coming to town. Everyone keeps trying to pressure me to go, and wanting to know why I am not going. Today I ran out of excuses so I just replied "I don't want to go". Why couldn't I have thought of something better than that? That just sounds rude. And I always try to be polite. I should have anticipated questions and had an excuse prepared.

Now, of course, I have started to worry. Is my over-sensitive, bad mood the result of a rapidly falling progesterone?

Is it already over?

I nearly did the POAS today (actually my HPT requires me to pee elsewhere and then use a dropper, but POAS sounds better), but I stayed strong. Mostly because I was too scared to see a BFN. The next few days are the hardest part of the 2ww. So close to the endgame. So much to lose.

Act how I want to feel. This is an important commandment. I know it works. I know that if I can just act happy, I will start to feel better. I could start singing. Singing usually makes me feel happy. I sing often. I sing all the time when I am in my car. But, lately, I have been singing along with Leonard Cohen...and these aren't really happy tunes (as much as I can see the beauty in his lyrics). I could try smiling. Actually "smile" may be my 2011 theme. I am smiling right now actually. I think it may be helping, a little. The quivery sensation around my heart seems to ease when I smile. The Vampire Diaries has just come on TV and those cute abs are also distracting me from my angst (a little).

So, what remains in my list of personal commandments? Live life every day? I'm still breathing, that will have to do for today. Love being me? This one's usually easy. I'm pretty cool with who I am (well, most of the time anyway). Sadly, it's not so easy to love being me at this time in the 2ww. It's not so easy to be stoked to be me when I have spent the evening stressing over the extrapolated subtext of a festive greeting card.

This blog has been a distraction though. I still feel anxious and worried about whether or not I'll be proven pregnant in the next few days, but I am no longer angry. Thanks blogosphere. For acting as a vacuum into which this little violin can vent her music.

*****

Make Me Up!

2010-12-05T19:01:00.005+13:00

For a while now I have been thinking I must learn how to apply make-up. Properly that is. In a way that actually enhances my features rather than just covering them up.

When I was circa 18-21y, living in the UK and France, I would not step out the door of my apartment without a fully made-up face plastered on. The thought of someone I knew actually seeing my REAL face as I darted out to the corner shop for a baguette in the morning, was simply too terrifying an event to risk. A boyfriend (they were all boys in those days, not really sure when they became men...) seeing me in the morning with a freshly washed face was just not an option. I was afraid they would be disappointed with the untouched version. Back in those days, I was quite adept at applying three shades of eyeshadow in some fantastic blend, and never went anywhere without my black kohl pencil. Even when I was backpacking and sleeping in railway stations...

Once I shrugged off my career in pint-pulling, room-servicing, and general bumming-around-Europe to return home for life as a student, I stopped wearing make-up. Totally. None at all. It was LIBERATING! People who met me at University only knew my real face, they had no other expectations. I still wore a little make-up if I was going out on the town at night, but never during the day. Life was easy. Ponytail and freshly washed face, the perfect regimen for student life.

Sadly, those heady days of medical school are now long behind me and over the last few years well-meaning females have begun to subtly suggest that "maybe I should try some lippy", or "perhaps a little mascara". Time to face the truth. I am no longer that fresh-faced jeune fille who can get away with ponytails and under-eye concealer alone. Now that I am 40y (with the same MAC beige eyeshadow I bought in New York in the winter of '96), I feel it's probably time I started "putting my best foot forward" and artfully concealing some of the facial degradation I have accrued over the last 20 years.

Interestingly, I have discovered that my self-acclaimed blending & highlighting artistry with eyeshadow is a long lost talent. Applying eye make-up it seems, is not like riding a bike. I just don't get it anymore. Any attempts to experiment have ended up with a pseudo-gothic clown-like physiognomy that I am just not able to carry off in my little ultra-conservative medical ecosystem. My colleagues and patients may reach the conclusion that I am having some type of mid-life crisis. That would indeed defeat the purpose of putting my best foot anywhere.

So, after extensive research and some trusted advice from J (aka my fashion advisor, stylist and BFF who always looks ultra-glamorous...even when she has just given birth!), I booked an appointment at the Bobbi Brown kiosk. The BB lady was very nice, but she seemed a little inexperienced and had to get advice from her senior colleague all the time. The foundation that she chose initially made me look like a corpse. Ok, this look has it's place, but not in a GP's office (if at all possible). Her colleague suggested another hue which blended miraculously into a healthier (more alive) looking face. The lipstick she chose after careful consideration was a deep pink that she covered in gloss. On someone else it would have looked fabulous. On me it didn't. I glanced over my shoulder and pointed at the very first lipstick that caught my eye, it suited me perfectly.

Then the eyes. What can I say? I wanted to learn how to blend neutral tones to give a natural (yet popping) day look, and then a smoky, sexy alternative for night time. I walked away with something in between. Something a little scary. As I walked around town for the next hour casually shopping, people kept doing a double take. I'd like to think this was because my eyes were "popping" in an insanely attractive manner...but I suspect I just looked insane. This is of course when I bumped into Mr High School (MrHS) and his wife (and beautiful baby). I'll tell you about him another time. Needless to say, crazy eyes were not exactly what I had hoped for.

My Bobbi Brown story is not quite complete. Not only did I have to endure bumping into MrHS whilst looking decidedly freakish, but I got home to find that my left upper eyelid was beginning to swell. What to do? I thought maybe it would settle overnight, but on waking this morning I could hardly open my left eye and looked a little like the elephant man.

After catastrophising dramatically to J on the phone (did BB lady give me bacterial infection? Or worse, was that a coldsore she had under her nose?? Was I headed for peri-orbital cellulitis?? Would aciclovir +/- antibiotics cause IUI#9's PUPO fetus congenital deformities? Should I take an oral anti-histamine? etc), I decided to take the oral antihistamine (5½dpo, so implantation unlikely to have happen yet) and go get some PUPO-safe eye drops from the pharmacy. They have worked, and my eye is almost back to normal.

Phew! The first hurdle of the 2ww has been surmounted (with only a slight neurotic break and a pinch of over-dramatisation). Onwards towards implantation!

*****

Social Infertility

2010-12-03T23:34:00.012+13:00

I came across a medical article today whilst happily googling away and reading about infertility. It kinda made me mad, and so I got to thinking about social infertility and what this means. To me.

First, some definitions. Primary infertility is used to describe people who have never succeeded in conceiving despite their best attempts. Secondary infertility refers to people who have had a pregnancy in the past but are unable to conceive again for whatever reason. These are the terms used to describe organic, physiological, traditional, emotionally devastating infertility. Then, there is social infertility.

Fertility NZ proposes that the term "social infertility" describes individuals who (not by choice) have not found a life partner, or have experienced a relationship breakdown, and find themselves confronted by biological time. They go on to say that: it is important to recognise that the thoughts and feelings of people affected by this issue can be just as real as by those who do have a partner and are experiencing infertility issues.

This definition sits well with me. Not by choice. CONFRONTED BY BIOLOGICAL TIME. That's me. I suffer from social infertility.

The offending article disturbs me because 1) it is written by an Obstetrician Gynaecologist for the Royal Australian and New Zealand College of Obstetrics and Gynaecology (RANZCOG) journal thereby lending it professional credibility, and 2) it was only published 4 years ago, meaning there remain practicing O&G specialists in the Southern Hemisphere today with these beliefs.

The author's views on single women seeking assisted reproductive healthcare included the following statement: Assuming that we have a sperm donor available who is agreeable for his sperm to be used for the treatment of single women [as I have previously mentioned most NZ donors actually exclude single women] the only argument is whether motherhood in a healthy woman is a right or a luxury. The individual doctor’s answer to this question determines whether he will treat the patient or not.

He talks of women (married or otherwise) who have deliberately delayed having children (which he suggests indicates selfish and distorted priorities). He illustrates this with examples such as:

1) The woman who didn’t meet the right man until she was in her mid-thirties. She also has a career and one sometimes wonders just how receptive she was to a long-term relationship and marriage in previous years.

2) The woman who deliberately delays marriage until she has completed university, had a couple of years working overseas, the purchase of a house, the elimination of a mortgage and the purchase of a luxury car.

(You can read the full article here if you are interested in his views on lesbians, military couples and DINKs).

What a dick. It annoys me that this "opinion piece" even managed to get published.

I am one of the growing ranks of women enduring social infertility. I also have delayed fertility (I am 40, so are my eggs). And, after 8 failed IUIs, who knows? I may even have primary infertility (or is that secondary infertility due to IUI#2's implantation?). But, does this really matter? Does the correct label make any difference in the end if I can't fulfill my dreams to have a child?

Did I choose to delay my attempts to have children? No. I was ready to settle down and start a family when I was 23. Did I put my professional career, travel, mortgage or Nissan Pulsar hatchback ahead of having a family? What??? No! They are all just collateral accumulations made during the long, long wait for Mr Right. That guy who was supposed to father my children. (And no, before you suggest it, I am not too picky, there is simply a man-drought in NZ. I understand they have a surplus in Alaska?).

Yes, I have delayed the decision to become a single mother. The decision to use a donor to father my children. To go through artificial procedures and hormones (let's face it, sex is better), handing over control of my body to others, in order to conceive. It was a tough decision. I didn't want to have to make it. It wasn't what I wanted for my life. It certainly wasn't the result of selfish and distorted priorities.

I wanted the traditional cliché, instead I became the modern one.

So, here I am. 4 days into the 2ww, reading crap like this written by people who should know better and feeling the need to justify my own personally disappointing experience of fertility.

IUI#9 may yet bear fruit and I could still morph from PUPO into M2B (I had baby dust sprinkled at me today on twitter, is that relevant?). But for now, I remain the same as I was yesterday: single, fabulous, professionally successful, and dependent on a cook catheter to get knocked-up.

*****

The Long & Winding Road

2010-11-30T13:29:00.003+13:00

Why does it have to be that my last IUI is totally dependent on an egg from my right ovary? I know for certain that my one and only pregnancy had a left ovarian contributor because I felt the ovulation pain. There. On the left. I would never have considered this to be an issue until my HSG showed that the left tube is the fallopian equivalent of a four lane highway that my young eggo can freely tumble along whilst the sperm blat up towards it at breakneck speed. The long and winding road that is my right fallopian tube is the scenic route. It is tortuous and thwart with delays and U-bends. We know that sperm never stop to ask directions...will they get there in time? Or will they stop in a picnic area for a pie and nap on the way? (If you knew the donor, you'd know that this is a strong possibility).

All this made worse by the fact that timing has once again not been quite perfect. Although the dastardly MrX (who has, in truth, been an absolute gentleman at our last two meetings) has reassured me somewhat that it is actually good, and that despite suspicious pelvic twinges this morning, I will most likely ovulate this afternoon.

My urine LH was negative yesterday morning, so I went for a blood test (which takes 3-4 hours to get the results). The USS was good. Perfect in fact. 10mm endometrium, 20mm follicle. All systems ready. So what were the options? Ovidrel trigger just in case I didn't surge on my own and a booking for IUI this morning 24 hours later. This plan was dependent on my labs showing I wasn't surging already, on my own.

1pm yesterday I get the lab call, all good in terms of progesterone and oestrogen but yes, LH has started to surge at 14 (so only just starting). Now, usually here in NZ, they do the IUI on the day of your LH surge so that the sperm is ready and waiting in the tube to ambush the egg when it unsuspectingly cruises on down. They only do one IUI, not two consecutive days like some places in the world, so you have only one shot to get the timing right. No one knows how long it takes for sperm to get themselves up into the tubes (odds are they probably fart around for a while), so there is always going to be an element of guess-timation, but everyone agrees that the sperm should be en route first. As it turns out, they decided to keep the IUI for today rather than late yesterday afternoon. This seemed fine when the nurse told me, but then I spent all afternoon at work second-guessing the decision. And worrying.

Having had the ovidrel trigger shortly after the start of my natural surge, this would act to enhance it and really, I expected to ovulate about 24 hours later. MrX thinks that with the ovidrel it will be about 36 hours. Ovidrel was given at 10am yesterday. IUI booked for 10.20am today. The outlook was sunny with a small chance of ovulation prior to procedure. Relaxed. Happy. Optimistic with only a shade of pessimism.

I arrived early for my appointment. A little excited, which is nice as it's been a while since I felt any kind of joy associated with the clinic. I got changed into one of those nudie gowns, went to the harvesting theatre (the only room free) and assumed the position. I waited with the fertility specialist who was booked to do my procedure (MissX) and we looked at photos of the U2 concert (awesome) on her iPhone, whilst my lovely nurse went to get the swimmers. Then the bombshell. They FORGOT to defrost the sperm!! What?? And it would take the lab an hour to defrost them? And the clinic was fully booked. So, they would have to get MrX to squeeze me in. But, of course.

Anyway. All's well that ends well I suppose. The procedure was quite pleasant, MrX was charming (and did not suggest super-sizing the speculum), and they have a new sound system that piped Mozart through the room so I felt pretty relaxed about it all. My nurse said this will be the longest tww of her life! (Bless her). MrX suggested they will start a pool at the clinic to see if I go on to require IVF or not. I wonder what odds they are giving? I am having an early blood test on Monday to check progesterone and they may support the luteal phase if it's not looking juicy. (This is new, and was only offered because I enquired about the use of those progestagen suppositories that I've been hearing about on twitter. I doubt I will need it to be honest, but it's nice to know they are thinking about how to maximise my chances this cycle).

As I write this I am lying on my bed with my legs up the wall. I am aware that this has no bearing on ANYTHING, but I just want to discourage those young swimmers from lingering too long in my uterus. Given the convoluted nature of my right tube, maybe I should just be outside doing cartwheels? Actually, that's not really a bad idea...although the last time I did a cartwheel (about three weeks ago, just to see if I still knew how) I pulled a groin muscle. This reminded me why even "young" middle-aged women don't generally do cartwheels. No matter what you see on TV. No matter how easy it looks. Although, I suddenly have a strong desire to retrain my body to be able to cartwheel again. At will, anywhere, anytime.

The 2ww has begun. Watch this space.

*****

Friendship

2010-11-27T16:38:00.001+13:00

I have been thinking a lot about friendship today.

I believe that there are just as many types of friendships as there are people and every friendship is different. I considered how I would categorise my friends today (eg. close, personal, professional, virtual on-line, casual, acquaintance, collegial etc.) and realised that the people in my life don't fit nicely into categories. There are just too many overlaps, too many exceptions.

My friends are simply my friends. Some of them I know well, some of them I don't. Some of them I spend lots of time with, most of them I don't. The one thing they all have in common, is that they bring me a lot of happiness.

On the whole, friends tend to come and go throughout your life. It is sometimes sad (or devastating even) when a friendship is lost, but most of the time in adulthood it is a gradual parting, where changes in location or situation dilute contact until it is lost for good.

The birth and demise of friendships is not necessarily a bad thing, as more often than not people arrive in your life just when you need them to. They help you out of a jam, or through a difficult time, or offer you new opportunities and then they move on. This is life. This is how it should be.

If you are lucky, there are some close friendships that will endure, in some form, throughout your entire lifetime. My longest continuous friendship, with someone not related to me, is 26 years. Most of my close friends I have known for over 15 years, but they haven't always been personal friends. Close friendships can blossom out of prolonged acquaintanceships, or from the strangers you meet randomly, click with instantly, and wonder how you ever got by without them in your life before now. Some of my closest friends belong to my extended family.

And then, there are the social networks. I am grateful to Facebook for helping me reconnect with old friends, classmates (except for that stalker guy) and acquaintances - some of whom have developed into good friends in my real life. I am also grateful to the Twitterverse for the anonymous friends who have welcomed me into their network of tweeps (and sometimes read this blog).

Sadly, I have a friendship dilemma today. I have been spending a lot of time this last year with a new friend, and I have come to the uncomfortable realisation that she is a friend of convenience. Our entire friendship has been based on the fact that we are both single female doctors. It has been years, since I last had a single girlfriend to hang out with on a Friday night and I have loved the idea of gossiping on the phone, shopping and doing regular girlie (sex-and-the-city-esque) things with another singleton.

However, we don't actually get on all that well. She snaps at me a lot and frequently gets offended by (misinterpreting) things I say. For example, I knew she was in the middle of doing a lot of work on her garden so when I popped over for a visit, I said enthusiastically (smiling broadly) about her garden "it's starting to look REALLY GREAT!" I meant this as a genuine compliment but it really upset her. Why? Because I had said "starting", implying to her that 1) the garden hadn't looked great before, and 2) that it still wasn't actually looking great yet.

OK, so "starting" in retrospect was a poor word choice, but the sentiment behind the message was good. It wasn't some passive aggressive, backhanded compliment to make her feel belittled. That's not the type of person I am. I like to build my friends up and celebrate their successes. I would never intentionally make them feel bad or inadequate. A friend would know this about me.

The example above is just one of the many times a seemingly benign comment has received an unexpected and bad reaction. Every time this happens I apologise and we move on, but gradually I have become aware that she is controlling, frequently impolite, moody and I am not convinced that she has all that much regard for me. Do I even like this person? (I thought I did...).

So here I find myself, contemplating how to actively end a "close" friendship. This is not something I've had a lot of practice at (ie. zero practice), but the fact that I am contemplating it at all tells me this can't be a healthy friendship. I feel like a bad friend just writing this. Maybe it's something I'm doing? (Like stupidly using the word "starting"?) Maybe I could limit the friendship to less contact? (We do have some fun and lots of mutual friends). I am undecided. How do you end a friendship without hurting the other person? Can it be done? Am I an awful person for considering it?

What I do know, is that I am not comfortable with continuing a friendship for convenience alone. I have always maintained that life is too short to spend your personal time with people you don't get along with or who make you unhappy.

Help?

****

Happiness Renaissance

2010-11-24T12:52:00.003+13:00

OK, so the CD8 update is that my right ovary appears to be having a party with a packed house (I do not approve). Fortunately there is one dominant follicle so it should suppress the others. There is also someone home-alone in lefty but she's too small to factor into this equation. The dominant follicle is borderline in size for a Saturday IUI (Sunday would probably be perfect, but of course the clinic is closed. *sigh*), so I will await the oestradiol rate of change between today and tomorrow's lab tests to decide whether or not to trigger while I'm away. If I have not already ovidrel'ed myself Friday morning (on basis of lab results), I will then have an USS Friday afternoon once I get back from U2 (direct airport-to-clinic transfer) to decide whether or not to still trigger Friday afternoon (on basis of follicle size) for a Sat IUI or to wait for a Monday procedure (with a Sunday trigger). Don't ask where the LH POAS fits into all this (because I'm not too sure about that myself!). Confused? Welcome to the world of artificial reproductive technology and consider yourself very fortunate if you got your babies the old-fashioned way. Very fortunate indeed.

I have been thinking today about the renaissance of my Happiness Project. This blog replaces the online project that I started with Gretchen Rubin just over a year ago, that rapidly began to gather virtual cobwebs as I steadily pounded my days aways on the fertility rat wheel and failed to nurture the things that make me happy. I subscribe to Gretchen's philosophy wholeheartedly. Happiness is something we make for ourselves everyday and, as with anything worthwhile, it requires a little nurturing and some thoughtful maintenance.

My brain is rather mathematical in the way it processes things and by my calculations: 8 failed IUIs in 12 months approximates 67% unhappiness + protracted brooding spells and blaming of unjust universe (10%) + random bad days (1%) = 78% unhappy days versus 22% happy. This is the mathematical summary of my year to date. I'm not happy about it. If this is my happiness tax return then I am clearly due a refund.

The following links are some of the inconsequential little things that have made me happy this year. I thought I'd share them so that they can, perhaps, make you feel happy too.

This first video is "40 Years", by The Phoenix Foundation and is filmed in Lyall bay in Wellington (you may recognise Taika Waititi looking truly awesome in his maroon tracksuit). It provokes so many pleasing childhood memories of 1970s New Zealand and I have adopted it as my theme song for the year. A self-tribute to my own 40 years of being Kiwi.
http://www.youtube.com/watch?v=Mz5qUPpuAFM

If you're a fan of Nick Cave, or if you are a dog-lover you should enjoy this next link. It's one of those tragic stories that still manages to make you smile... http://www.youtube.com/watch?v=PyNrt1nY7P8

Next, Missing Missy. Every single time I read this, I cry. Tears of laughter. I even laugh when I watch other people reading it in anticipation of their own snorts and giggles. Strangely, not everyone has found it funny? I am a cat-lover, and I don't find it at all offensive!
http://www.27bslash6.com/missy.html

Finally, a children's song by Fatcat and Fishface. This one comes with an advisory warning: do not even bother to watch if you don't find dark, creepy, weird, quirky little things at all interesting, as the song may stick in your head for an extended period of time and really annoy you. I love it, I don't know why, but it makes me happy. (Please note: I have only found one friend who shares this love). The NZ lesser short-tailed bat is the only mammal native to this country and like so many other ancient native species it is endangered.
http://www.youtube.com/watch?v=YkbqUdtj86A

If you want to share any happiness triggers with me, please leave me a comment and a link :)

****

The 2ww and Cocktail Parties

2010-11-23T12:08:00.002+13:00

CD7 and counting. IUI#9 the ultimate round of procreation-by-catheter for 2010. I have my first monitoring blood test and USS tomorrow. I am hoping to see a follicle approaching 18mm and a good-looking oestradiol that will reinforce my plan to inject the ovidrel trigger on CD10. Fingers crossed. Because of the clinic being closed on Sundays, and my trend towards 23 day cycles, I have only one day available for spermification (no this is not a real word) this cycle; CD11. I have a good feeling about CD11. 11 is a good number. I was born on the 11th. Completely irrelevant I know, but my brain will make even the most tenuous of links appear significant when it comes to TTC. I can't escape it though, 11 does feels right.

Despite this, I have already started to plan my transition to IVF next year. I feel a little guilty about this. Somehow it feels disingenuous to my IUI#9 to be planning for it's eventual failure. Clearly I don't want it to fail, but in the last couple of days, for the first time, I have begun expecting it to fail. Maybe this is actually a good thing because the previous 8 IUIs I fully expected to succeed. And they didn't. So perhaps this contrary universe, for the first time in TTC, will bring me what I want? It does seem more than a little ridiculous to me to be forking out $1320 for an IUI procedure that I expect will fail. I guess it is a bit like gambling? Actually it is a gamble. So for now I will indulge in another hand of poker and see which cards I get dealt. If I have to fold, I can turn to my IA (Infertility Anonymous) group for support.

I had some good news this morning. A friend who is a fertility specialist (and someone I really trust) is moving back from the UK next year to work at my local clinic and has offered to be my doctor if I do IVF!!!!!! I am very pleased about this. Very, very pleased. Those of you who remember MrX will appreciate why I am slightly reluctant to have him baking my embryos. She was a little concerned that I may be being overly optimistic about my ability to put embryos on ice, and pointed out to me that many woman don't get enough embryos for this. I have informed her that yes, due to my optimism disorder (which I refuse to medicate), I fully expect to have lots of juicy eggs harvested, that will go on to make lots of robust embryos, that will all survive. I have also reassured her that I am realistic. I am aware that there may only be a few eggs harvested, that they may be duds, and that all of the embryos created may arrest their development before transfer or freezing. I have looked at the IVF stats for number of eggs harvested, number of viable embryos and number of live pregnancies. I accept that for my age group, they really suck.

For the last year my entire life has revolved around TTC. My plans to do my first triathlon were benched after my first IUI was timed for the day before and I wasn't going to risk over-heating my egg. My work Christmas party (cowboy themed mystery tour with skeet shooting and line dancing) entailed excuses about why I wasn't drinking. My road bike and running shoes gathered dust as I became paranoid about doing anything physical in the 2ww (even though I "know" it doesn't make a difference to the outcome, I still don't really "believe"). I became the sober driver for every fun event and then always regretted not having had that glass of champagne, that taste of listeria platter (because I wasn't pregnant after all). I have pretty much worked part-time all year as well, to keep my mornings free so that I can run off to the clinic at a moment's notice without having to rebook my own patients. This has not been the best strategy for building the finances required for never-ending fertility expenses. Now, I can't run more than a block without respiratory distress, I have forgotten how to swim, my legs refuse to pedal my bike up even the slightest incline (and have started to wobble in ways I just don't appreciate), and I have a rather sad looking bank balance. Silly sacrifices really, in the big scheme of things, but I still resent having made them for no gain.

IUI#9 comes at a time of Christmas functions again, and I have been thinking...well a glass of champagne in the 2ww, pre-implantation, is not going to hurt. Is it? Probably not, but my conscience is a powerful mistress, so I guess I will be politely declining cocktails at the cocktail function I'll be attending next week. Again.

Talismans and Compensatory Spending

2010-11-20T10:28:00.014+13:00

I looked at my Mastercard balance last week and nearly fell off my chair in shock. Disbelief, denial, grieving and then finally acceptance followed (thanks Kübler-Ross for putting this into perspective for me). I have never been especially thrifty (Hey, I'm a single woman with a great income and only myself to spend it on!), but I've never been a spendthrift either. I'm pretty financially literate and I like to save more than I spend. I am also a little risk averse when it comes to accumulating debt - although you wouldn't know this if you saw my mortgage balance!

Anyway, on reflection I believe all this spending has been a subconscious attempt at retail therapy to dull that constant ache that comes from the repeated disappointments of failure to conceive. I have spent a small fortune in the last month on beautiful clothes from a NZ designer's off-the-rack collection. I am not even sure where/when/if ever I'm going to wear one of the dresses.

(This is not me in the dress by the way, the photo is from the catalogue and doesn't do justice to the vibrant green silk which is stunning in real life). My friend has christened it my "Paul Walker" pulling dress, i.e. the glamorous dress that I would wear if I ever had the opportunity to go on a date with a very sexy/handsome man. Hmmm, the odds are not all that high (refer to last entry on NZ man drought). Thursday I was walking down the boulevard of broken dreams when I happened upon a shoe shop. I LOVE my new strappy shoes :) They definitely give me a happiness boost, so why not? Generally I find the buzz of retail therapy doesn't last all that long, so I am going to make some conscious changes, follow Ireland's lead, and put in place some new austerity measures. After, that is, I get back from my girl's trip to see U2 and raid the Auckland shops.

Just a week ago I was feeling very confident that I was in fact pregnant. Of course I wasn't, it was only the stupid ovidrel that made my boobs swell and told my body there were baby hormones in my veins. I found myself one evening researching cots on the internet. Cots? How did I get there? I have been very strict about what I am allowed to focus on since my early miscarriage, and it does not include buying baby things. Nor does it include redecorating my spare room into a nursery (you can't, it seems, buy a cot without considering the entire room it will go in). In the early days, when I was convinced I would have a baby in my arms by now (I come from a long line of overly-fertile women) I bought some baby clothes. Just a few absolutely gorgeous (must have) items. And a small knitted bunny rattle that has since become my baby talisman.

I sometimes get these clothes out and look at them, but they make me feel sad. And stupid. And then I wonder if I have jinxed myself by tempting fate to have a laugh and withhold babies just to spite me. After I have had an IUI I often sleep with my baby's bunny rattle on the pillow next to mine. I like the the little jingle it makes (angels getting their wings?) and I imagine my baby smiling at it, reaching for it and sucking on it's ears. It hasn't helped to bring me a baby yet so I guess it's not a very good talisman. Somewhere towards the end of the two week wait, I reach the point where I have to put it away so as not to see it (or the baby clothes) and be reminded of my grief.

I saw an item on morning television a few weeks back that was about attracting your soulmate by writing a letter to your "angels" and putting it under your pillow with a rose quartz crystal...ok, so sounds kind of lame, but I have a cousin who is into all this crystal stuff so I thought, why not write a letter to my baby?

My cousin kindly gifted me a little rose quartz crystal and I wrote a heart felt letter to my future child and placed it all under my pillow just prior to my last IUI. It gave me more hope. I even felt a little excited about it. (To be completely honest, I also wrote a "soulmate" letter. I figured it couldn't hurt?). So far, all that has happened is that I now have a sore neck...something about having a small rock under your pillow.

So here I am, transported into a world of fertility talismans, with a big credit card bill (not to mention the black hole of the fertility clinic expenses) and hoping I haven't picked up any bad juju along the way that will thwart my plans to propagate.

Optimism versus Cougarism

2010-11-19T20:09:00.005+13:00

So good news from CD2 labs and USS. No early recruitment of follicles and oestradiol has fallen to 0.1, just where it should be. It's hard to know what happened last cycle and why my LH didn't surge, but I am going to give it another go. It kind of bothers me when I mention to staff at the fertility clinic that I think the IUI was done two days too late last month and they agree with me. Why wasn't one of the fertility egg-sperts paying attention to my cycle monitoring? I have decided to take a bit more control this cycle. This, MY LAST IUI CYCLE. (Yes, I have decided IUI #9 will be the last of it's type). I figure that if I get the timing wrong, I can live with it. I know my cycle pretty well by now and have a pretty good idea of when things should happen, plus, I intend to use an ovidrel trigger (provided there is a decent enough looking follicle) and not wait for my own seemingly unreliable LH surge.

As has been my experience with IUI, there is always at least one roadblock to smooth sailing. Today I realised, that not only is my best IUI day likely to be Sunday (again) when the clinic is closed, but also I am going out of town to see U2 in concert on Thursday (awesome!!) with a group of girlfriends and not getting back until Saturday afternoon. Sigh. So, after last minute flight rebooking, cancellation of Friday plans, booking of early USS and bloods (including a blood test on the way to the airport!), and take-out ovidrel for use pre-return flight...it is all sorted for a Saturday morning IUI (27th Nov). This is, of course, dependent on what the bloods and USS show on CDs 8 and 9, but I am happy with my plan and am feeling decidedly optimistic (I may have mentioned that I have an optimism disorder?).

I have just gotten off the phone from the friend I was supposed to be catching up with next Friday, she is a women's health doctor and completely understands why I am bailing on our plans. Her suggestion is to go out and find a nice young man for a one night stand and then take prophylactic antibiotics before implantation (for potential chlamydia and gonorrhoea infection). IF ONLY it was that easy. It's not or I would have done this already. I have thought about it of course, it would be a lot more fun than IUI treatment and a hell of a lot cheaper! (If you disregard the emotional cost of luring an unsuspecting male into your baby quest). There is no solid evidence yet that I have reduced fertility (although after 8 IUIs people are starting to wonder, and by "people" I do mean me) so I do often wonder if I am being a fool doing the frozen donor IUI option. Average sperm probably lives about 5 days (super-sperm maybe 7 days), washed/frozen/defrosted sperm has about 1 day in it for action (up to 3 if you are super-lucky). Given that my egg has 12-24 hours of life, there is a damn narrow window of opportunity for any meaningful wow kismet relationship to occur in my fallopian tubes.

It's so hard to know which path to travel. I am thinking about doing an IVF cycle in Jan/Feb if IUI#9 fails to fire. I really never thought I would entertain this option as it seems such an incredibly difficult process to go through (let alone to do as a single woman), but I am starting to think the smart option may be to have some embryos on ice for the future. Hopefully I won't have to action this plan.

The move-to-Europe-and-live-wild-life plan still appeals to me very much. I think it may be my back-up plan if I don't succeed with TTC. Maybe there are more men over there? There have got to be eligible men somewhere in the world? Surely?? The NZ census has confirmed what women here have known for some time, that there is actually a MAN-DROUGHT in NZ. It's official. Actually, it is only in the 30-40 age group (i.e. my range) so there are lots of 20 somethings and 50 plus's around. I have heard all sorts of theories on where the men may have gone (1. NZ men tend to travel and marry foreign women, whilst NZ women tend to travel and then come home looking for a man. 2. Alien abduction. 3. Australia...etc), but who knows really?

Last New Year's Eve I christened 2010 "the year of the cougar". I was only half serious but my friends thought it was hysterical and I don't actually have a problem with dating younger men. Why not? In the last three years the only men who have hit on me have been 25. I don't mean "about" 25, I mean exactly 25. It's been strange, and kind of flattering, but really, do I truly want a boyfriend who wants to spend his time playing playstation; spends more time in the bathroom getting ready than I do (with more hair products); doesn't know who Leonard Cohen is; and is (literally) young enough to be my son? (Ok, I would have been a VERY young mother, but still).

So, for now at least, I will pursue the IUI dream one more time and see where it takes me.

IUI #8 has gone to custard...

2010-11-17T18:35:00.007+13:00

CD1 again. I knew it was coming because my labs two days ago showed a pitifully low progesterone. Felt like crap yesterday and didn't really want to get out of bed to face the world a non-pregnant, childless, manless, saddo. All this worsened by my premature belief that the IUI had been successful this time and that I was actually pregnant (had just got to 10 days post ovidrel trigger and I felt pregnant so was about to test when I got the no-go call).

Feeling a bit better today as my inexplicable optimism disorder is starting to kick back in. Have got to do a CD2 blood test and USS to make sure the last follicle wasn't just a stupid cyst. It is now clear that this IUI was done 2 days TOO LATE!!!!! (Due to lack of proper management... again). Am so frustrated by the process, at least for cycle 7 the IUI was only 1 day late (due to a dud urine LH kit, ?Act of God) so there was at least a chance of getting my eggo preggo.

My IUI experience has not really been all that enjoyable. It seemed to start off pretty well, but what did I know? Even as a medical physician who manages fertility in primary care, I still didn't question the lack of information, consent, investigation, management, follow-up, monitoring...

I may have already pointed out that there is only one fertility clinic in my town, and very few clinics in the entire country meaning in each city they run as a monopoly. I really liked my first specialist, he was lovely. My consent appointment he spent ten minutes struggling to find the right forms to print off the computer (new software) and I guess he thought because I was a doctor, I didn't require any information prior to signing my consent forms. So I signed, as one does when your options are severely limited. It cost me $250 to sit and watch a man play on a computer.

IUI #1 (The birth of hope) was a bit difficult. No one's fault, timing seemed all good (natural cycle and urine LH kit), but my cervix wasn't playing ball. I sometimes wonder if I should have listened to my poor internal os which has struggled so valiantly to deny access to invading catheters, maybe my body knows something I don't? Anyway, after 45 minutes, multiple devices, and an uncomfortable yanking on my cervix to elongate it...the first sperm were deposited. All good. Or so I thought, but no baby. Still, it was a start and I was happy.

IUI #2 (Close but no cigar) was an easier procedure, and again a natural cycle with no monitoring (did I mention that? You pay the same money (i.e. LOTS) as for the drug cycles but get no blood tests, no USS and no advice...). Anyway, this time I conceived, I implanted, and I felt pregnant! It was wonderful. I distinctly recall sitting at work, feeling my tummy and thinking about that little conceptus rapidly dividing in there. It was very exciting. Sadly, it didn't latch on properly and a few days later I had an HCG fall down to just 5. The nurse who rang to give me the results was awful. Transcript => Nurse (delivered in detached voice): "the HCG is 5." Me (devastated): "Oh. Well, I guess that's that then." Nurse (bored voice): "Have you bled yet?" Me (still devastated): "No." Nurse (perfunctorily): "Well, it was just a biochemical pregnancy." Me (wavering voice): "OK." Nurse (nil emotion): "Goodbye." Me (squeaky): "Bye" (bursting into tears as I hung up). I think this experience would have been much easier for me had the bad news been delivered by a caring, empathic person. If it had been handled differently I wouldn't still be feeling angry about it 9 months later. Breaking bad news is always difficult, I know this as I have not always done it perfectly myself, but showing some hint that you care about the emotional pain you are causing is really the easiest part. I have seen this nurse twice since and I always get the urge to inform her that not only are all pregnancies biochemical, but all people are too.

IUI #3 (Primum non nocere) was a disaster. After the miscarriage of justice in IUI #2, I was telephoned and asked to pick up a script for Clomiphene 50mg. I didn't really want to go onto drugs, natural seemed best - especially with conception capability already confirmed. However, I am one of those doctors who tend to do everything they are told when they are the patient (so as to not increase the workload of my colleagues and be the dream patient). I googled a medsheet on clomiphene as I wasn't really familiar with it, and then I took it. Five days of blurred vision and not quite feeling right followed, but hey, this seemed to fit in with the side effects on my data sheet so I persisted. (I was given the fertility clinic booklet 6 months later which stated clearly "if you have any of the following side effects [blurred vision], stop immediately and inform your doctor". Shame I never received any of this information about the medication at the time of prescribing. If you are familiar with the NZ health system you will know that there is an enormous emphasis on patient-centred practice, informed consent and respect of patients rights (dictated by the Health and Disability Code). Anyway, I survived my drugging and because of the suppression of my natural LH by the clomiphene I had my first blood monitoring and USS which showed a follicle on each side (ohh...twins?). After the USS, I was handed a brown bag (by evil nurse from IUI #2) that contained ovidrel to take at a later date. I hate to admit, but even as a primary care physician, I did not know what ovidrel was. When I got home I looked and saw that it was an injection. This was not what I had had in mind, and I felt I was trapped into an over-medicalised process which I had intended to be as close as possible to how nature would have done it. Again, no informed consent, no information at all (not even how to inject, but fortunately I had experience in injecting others. Still.). Anyway, on my way to work that lunchtime I received a call to take the ovidrel, now. Of course, the ovidrel was at home so I had to turn the car around and go back to stick myself. Very frustrating. This dose was 22 hours before my IUI. Hmmm. The IUI was on a Saturday and the doctor-on-call was someone I knew personally but had hoped not to bump into during my treatment. No option but to proceed. The procedure was terrible, the clomiphene has made my pelvic organs hypersensitive, and an oversized extra wide speculum was used (which got stuck and was extremely painful to have pulled out gradually in small jerks that replicated what I imagine a vaginal hysterectomy may feel like without anaesthesia). Then the difficulty in passing the catheter through a clamped down internal os led to the use of a tenaculum. I did not like this at all. I think my colleague felt pretty stressed and it was just a relief to get it over with. I bled for two days after this IUI, and in my mind I could visualise the big bites that the tenaculum would have taken out of my poor little cervix.

IUI #4 (Au naturel) went better. My lovely specialist (lovely but remiss in management duties) left town, so I no longer had anyone responsible for my management (or lack thereof). I made the decision to stop clomiphene and go back to a natural cycle, as why change a winning recipe? Again, no bloods, no USS, but the price had gone up in the interim. This cycle was uneventful and unsuccessful.

IUI #5 (Chickening out) was back on the clomiphene but at 25mg. My decision, I had no one to discuss my management with and CD1 had arrived, so after angsting for a week over whether or not my insistence to go natural was reducing my chances of conception, I caved and decided to go back to the drugs. This meant I had monitoring again and this time two follicles on the right ready to go. Ovidrel again. Simple procedure, but no bun-in-oven at end of the waiting period.

IUI #6 (Unbelievable...) was another clomiphene 25mg cycle. This was the cycle that nearly broke the back of my quest for motherhood. I had made an appointment to see a specialist (henceforth known as MrX) so that I could have a management plan made for the future, and so that I could have my questions answered (I had a lot of questions, like for example "why haven't I had an HSG?"). Unfortunately, as things turned out, my IUI timing coincided with the day of my appointment so the nurses organised for MrX to do the procedure after my 30 minute appointment. Seemed like a good plan? It wasn't. I arrived early for my appointment (collegial respect) and sat and waited. I waited throughout the entire time of my appointment (ok, so he was running late, I am a patient patient), and then was told to go to the treatment room for my procedure. I was stunned and caught off guard that my appointment, which I had so much invested in, had been cancelled (because MrX was running late). Whilst positioning myself for the IUI, the nurse asked if it was ok for a "new doctor" (the reason MrX was running late) to come into the room. I said no. NZ is a small country, the medical world is even smaller, I really didn't want to meet another colleague with my knickers off and my legs in stirrups! MrX brought her in anyway and when the nurse protested on my behalf he insisted she must remain. Even though she knew I had said she couldn't come in, she stood next to me for the entire procedure. (I found out yesterday that she is a new obstetrician in town as she sent me a personally addressed introductory letter. She won't be getting any patient referrals from me). Next, MrX suggested he needed to get some "tools". I told him that he wouldn't need a tenaculum (because there was NO WAY I was having one of those things near me ever again!), but he insisted he would use one if he needed (wanted?) to. At this stage I started crying. Those silent tears that just pop out of your eyes despite all efforts to keep them in their ducts where they belong. Damn it. I never cry in public if at all possible and I hate appearing "fragile" to male colleagues. My crying was largely ignored (except for a tissue handed to me by the intruder). Next came the battle-of-the-speculum. I politely suggested that he use the smaller speculum (i.e. the standard size used in primary care for non-multiparous, non-obese women) as I had spied the wide one from IUI #3 on the tray. He argued for several minutes with me that the large speculum was in fact a medium sized one (it wasn't) and that it would be less painful to have the larger speculum inserted into my vagina (like he would know). I held my ground and he then asked if I "had something wrong" with my vagina "have you had surgery" or something? No. No. No! The actual procedure was painless, quick and easy, but my attempts to ask questions about my management were hushed and spoken over with his own agenda items (including a dissertation on how to do a speculum examination, which given I am a female primary care doctor who has lost count of the number of speculums examinations I have performed, was entirely redundant). After the procedure I was understandably upset so he took me into his office for a 5min chat (not really the 30min appt I had prepared for, and by now my brain was struggling to process information following the humiliation I had just experienced). At this time, he said "we normally do an HSG after the 3rd IUI" (this is when I was given the clinic booklet with the info about clomiphene in it, the booklet states they offer the HSG +/- laparoscopic hysteroscopy at the start of treatment). He also told me that after 6 IUIs I may as well go straight to IVF. Anyway, as you know by now, IUI #6 was an unmitigated disaster and yielded no good news.

So, here I took a break for a few months. Life isn't supposed to be this hard. Having a baby isn't supposed to be this hard. I couldn't believe how awful the fertility clinic process had been. How disrespectful. How inefficient. How non-transparent. It concerns me that this monopoly health care business is neither patient focussed nor customer focussed, does this mean it is entirely profit focussed?

IUI #7 (Taking control...) marked my return to the fertility game. I had organised an HSG which was normal, and I decided to leave the lap/hysteroscopy as it seemed a bit invasive (and I had already had one implantation, so now I knew both tubes were open I was confident it would just be a matter of time). This time I made another appt with MrX and told him what I wanted. I would go back to natural cycles - because I was concerned that the clomiphene had thinned out my endometrium I asked for USS monitoring mid-cycle to ensure things were looking good. This is when MrX informed me that for some women clomiphene does thin out their endometrium and reduce the chance of implantation...even that some doctors say it is indefensible to be giving it to women in my situation. Wow. If this conversation had taken place prior to prescribing me clomiphene I NEVER would have taken it! Just another example of lack of informed consent. This cycle was stressful. The urine kit didn't work, so when my expected LH surge day came and went, and two more days of negative, I took myself to the lab for a blood test. This confirmed that I had surged but was possibly on the tail end of it (actually felt ovulation pain later that day) so an IUI was done straight away. Maybe the sperm had a chance to swim up the tube before the egg died? Maybe. Anyway, no baby was made.

IUI #8 (Return of the Ovidrel trigger) Ok, I'm almost up to date with this blog. I promise I will never write such a long, tedious entry again. This one was another odd cycle. No LH surge happened, USS day 10 showed a large follicle on the left (22mm) and then the chinese whispers of the doctor-nurse-me-nurse-doctor started up again. I was persuaded to take an ovidrel trigger the next day so that I could have IUI on the Saturday (the clinic is no longer doing IUIs on Sundays!!! Just another level of stress added to the mix for women on "natural" cycles). Rumours flowed that maybe it was just a cyst and not an egg-containing follicle. More stress. MrX (yes, he was on call Saturday) reassured me that he wouldn't do the IUI if he thought it was a cyst, so I felt better about it all. Anyway, CD1 arrives 10 days later (my usual luteal phase is 12-3 days). Hmmmm.

As part of the discussion this cycle (i.e. my complaining has become vocal) I now have just two nurses assigned to my case, this means (for the first time) I will have some continuity of care. I was able to choose which nurses I wanted and they are both lovely. Things are looking up? So now, I am deciding whether or not to keep going. Should I just do IVF? (Loads of doubts there). Should I keep going with natural cycles? Should I just give up and move to Europe for a year of living wildly? (This one really tempts me).

Tomorrow I will see if there is early follicle recruitment going on in these ovaries of mine...fingers crossed there is not!

My cheap violin and my cross...

2010-11-16T10:35:00.005+13:00

No, I don't play the violin. No, I don't own the Stradivarius pictured (but would like to despite an inability to play it). No, this is not a music industry blog.

Yes, this blog is named after a line in a Leonard Cohen song (Take This Waltz) that just happened to be going through my head today. I thought it appropriate given that blogs are for musings, refrains and sometimes...the heartfelt laments that accompany the various crosses we each bear. (I saw Leonard in concert by the way, just 2 weeks ago. He was magnificent, of course, could he be anything other? Even at 76y he managed three standing ovations).

This blog is about me, and perhaps I am just like you. It's about my lack of ability to play the violin (for which I will always feel a touch of sadness), my singleton status (that I have not yet given up on transitioning into a smug-married status), and my decision to stop waiting for Mr Right to arrive in my life to bring with him all the things I have so longed desired: love, marriage, children, family, house, kitchen appliances, nice linen and so on, preferably in this order.

This blog is in fact my new Happiness Project. It is the way I have chosen to deal with the ups and downs of trying to become a mother when you just can't come up with the right father. It is a place for me to be honest and because of this I am writing it under the pseudonym Arohanui (Māori word, Google it. I like to very loosely interpret it as "I have a world of love to give"). I first started my happiness project a year ago when I started on this journey of becoming a "Choice Mom". At that time I was very happy, so it all seemed quite easy. Now the project is covered in virtual-dust from months of neglect, and I have decided to revive it in the form of this blog to help me regain focus.

The fact is I am very traditional. I always believed I would grow up, get married and become a stay-at-home mum. I am in total fact a modern woman cliché. My career was really only a diversion while I waited to meet my future husband. Now, I am forty, I have a successful career in medicine and business, and I can't help but think that maybe I didn't get the right advice when I was a girl? (My mother's only advice was "never learn to cook or you'll get stuck in the kitchen"). What I didn't realise was that attractive, capable and successful women have a much more difficult time finding a life-partner so they need to snap up the good ones early (they tend not to re-enter the market at a later date, and if they do, my observations have shown a mean time-to-next-relationship of only 3 months so you really need to be on the scene at the right time). I am so tired of people telling me "I can't believe you're still single", I can't believe it either, but I can see exactly how I got here.

I have only recently encountered the term "Choice Moms" which describes single women who use assisted reproductive technology to help them become mothers. In New Zealand, this process is not at all common. I had always decided that when I turned 38 if I wasn't in a relationship I would start down the path of single-motherhood. Unfortunately, in NZ, sperm donors are few and far between. Even worse, the vast majority will not allow their sperm to be used by single women (make of it what you will, personally, it pisses me off). So when I went to the one and only fertility clinic in town I was told there was no sperm available for IUI (intrauterine insemination), and my only option would be IVF (in vitro fertilisation). They had only four anonymous donors I could choose from (Really? Four??). Now, for a woman who had no known fertility problems (if you discount social infertility), the thought of jumping straight into IVF was a little too much. Unexpectedly, it brought up strong emotions of being a failure as a woman, and also some uncomfortable emotions surrounding having an embryo frozen and defrosted - how did this fit in with my ideological beliefs? Anyway, I opted out of IVF and was left with finding my own donor. This was the end of 2008.

Several months later, I received a phone call from an old friend. She and her partner had long discussed the idea and had decided that he would offer to be my donor. I was blown away. This was something I would never have been able to ask of any of my friends, so having an unsolicited offer was incredible. I was very touched, and very grateful. Even so, it took me several months of considering the pros and cons of having a known donor. (In NZ there is quite good legislation for sperm donation and all donors must be on the register but do not have any parental rights or obligations). It was an enormous decision but it seemed like the right one so I excitedly accepted and he began the long process of sperm banking, while I began the quarantine countdown (thank goodness the NZ clinics had only just reduced their quarantine times from 6 to 3 months).

My IUI journey started in December 2009 full of anticipation and excitement. It has not been an easy journey, and it has not yet been a successful one. My next post will be a scooby-doo wrap up of my IUI experience to date. I have at times lost sight of the big picture and forgotten to safe-guard my happiness. This blog is the start of my journey back to me and maybe in the process, someone else will find something useful in my story that can help them with their own journey.