If you thought guessing *dress* size of a stranger was hard….

I suggest that you try guessing what size speculum is going to be suitable for a given woman’s pap smear. I’m just never quite sure, and it’s not the best of situations to come into without the proper equipment.

I know that many women feel embarrassed about what their doctor thinks about seeing them down there, but don’t worry. Really. At least in my case, all my thought is focused on getting the speculum choice right, tactfully. I don’t care what it’s like down there, as long as I guess the dimensions more-or-less accurately.

Purple pubic hair is ok, people. I also don’t judge Brazilians.

I just want to avoid a mid-examination whipping out of the room for something a little, err, more robust (or petite). It isn’t really nice to leave some poor woman lying there, spread-eagled on the couch whilst one goes out in hunt of option B. So getting the selection of tools right, vagina unseen, is critically important.

If you don’t believe me, think on it for a minute. If you dare.

Women are all pretty different on the inside too, and no real way of establishing the territory exists.

You will have to trust me when I emphatically state that there’s absolutely, positively no tactful way to ask a lady if she happens to have a loose, bulgy vagina or not. Finding out if she happens to be post-menopausally atrophied (and needing some more delicate instruments) is no walk in the park either.

The closest approximation I have managed to come up with is a rough combination of age, bodily habitus and the inquiry ‘Do you have children?’.

If the answer is in the affirmative, I confirm that they weren’t Cesarean births, and go for something appropriately sized.

My current algorithm goes something like:

• Pre-menopausal + bigger + vaginal babies = big speculum
• Pre menopausal + thinner + vaginal babies = medium speculum
• Post-menopausal + no-babies = little speculum (gently!)

But you know what has me absolutely stumped, every time?

The combination of:

• post-menopausal + vaginal babies + bigger lady = ??

It could quite easily be any of the above options. I usually guess small, because it’s better not to hurt women ramming a too-large speculum up there, but it means I run a significant risk of the following event.

Imagine the fun to be had trying to find a cervix with a far-too-small speculum. Cranked open as hard as it will go. With redundant vaginal walls oozing around the blades. Enough to meet in the middle (completely obscuring any view).

Nice mental image, no?

Like Cindarella, but with my nose…

Otherwise entitled ‘The post in which I admit that I lack the most basic of co-ordination’.

I am now like Cindarella, but a nasally obligated modern-day version. If I don’t get to my magic bottle twice a day, I turn into the owner of a failed IVF cycle. Kind of like a pumpkin, but much more expensive.

I’ve started the Synarel spray. It sounded so damn easy. For only two sniffs a day, you too can be menopausal in no time. Irresistable, eh?

After all, what can possibly go wrong with selecting one (of only two) options in the nostril department, inserting the nozzle, squirting several dollars up my nose, and withdrawing?

Except the fact that I just can’t seen to get the sniff’n'spray sequence right. I had two goes this morning and most of it ran out the front of my nose both times. Neatly mimicking expensive runny snot. I couldn’t even blow my nose afterwards, just in case some of the spray was lodged up where it should be. Nice.

Obviously I suck, hardcore, at sniffing. Cocaine dealers take note. If I ever develop a habit, it’s really going to cost me.

My plan of action (barring any better ideas) is to give it the old college try again tonight and if I eff it up again I’ll just have to call my clinic in the morning.

Unless anybody has any helpful pointers to improve my woeful technique? Anyone? Mystery Reader?

PSSSSttt. The too-close URL has not reappeared, and I can now be solidly sure that it isn’t any of you. Thank you all for helping my detective work by posting. The mystery remains, but I’m becoming more inclined not to give a rat’s freckle.

Paranoia, paranoia, 1, 2, 3

Whispering from a dark corner, complete with sunglasses and a big coat…..

Maybe I need to lay off the jesus juice, but I’d swear that I’ve had a few interesting hits from computers rather too close to ‘home’. Computers that my IP lookup tool seem to think are possibly connected to my, gulp, clinic.

I hope I’m simply imagining it. I don’t want my ‘cover’ blown.

I like the freedom that true anonymity brings in the field of over-analysing the mundane. Of being able to say what my small little mind REALLY thinks about things, even if I’m wrong. How I REALLY feel about people, etc etc.

I don’t want to censor my mad rambings for fear of offending anyone I know. Or, even worse, have them think that I’m completely daft for often getting the wrong end of the stick about my treatment. Or, worst of all, leave them shaking their head in amazement at the overblown, histrionic fool that I am (in the ‘privacy’ of the Internet).

In the interests of my sanity, can I just plead that if you think you know me outside of this blog to not read?

I’d be beyond mortified to think that any one of the myriad of very nice, competent people involved in my fertility treatment had inside knowledge of just what a worrier I am. Or what I really think about things.

Thank you. This post will self destruct in thirty seconds…..

*Actually, you could all do me a huge favour and put my paranoid mind to rest by posting a comment. That way I guess I’ll know that my Mystery Reader is not sinister and the IP thing is a funny coincidence.

For all the men out there….

A theme song for semen collection.

To the tune of Michael Jackson’s ‘Beat it’.

You told your wife you don’t want to come around here
Don’t wanna show your face, you want to disappear
The white room’s in your sight and their words are really clear

So beat it, just beat it

You better run, after you do what you can
You’ve got an IUI, don’t be a stage fright man,
You want a baby now, better do what you can
So beat it, you’ve got to want it so bad

Just beat it, beat it, beat it, beat it
Semen now, or you’ll be defeated
IVF bound, infertility your fight
It doesn’t matter if it takes all night

Just beat it, beat it
Just beat it, beat it
Just beat it, beat it
Just beat it, beat it

Need to fill the jar, better leave when you can
Don’t wanna be a boy, you wanna be a man
The magazines are old, better do what you can
So beat it, just beat it ……

You have to show your wife that you’re really not scared
You’re trying to make a life, this ain’t no truth or dare
Friction burn, then humiliation,
Then they’ll tell you it’s fair
So beat it, you gotta want it so bad…..

Just beat it, beat it, beat it, beat it
Semen now, or you’ll be defeated
IVF bound, infertility your fight
It doesn’t matter if it takes all night
Just beat it, beat it, beat it, beat it

Protected: Be careful what you wish for.

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Protected: I know that it’s just a dream……

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Rock on!

 

Thank you, lovely Waiting Amy. I am so very susceptible to flattery, and your kind words made what was a blue day beautifully sunny.

To think that I was truly feeling like packing up my blogging bat and ball for being so dull of late, before I read your comment. Perhaps I have something to offer, after all.

Now to spread the pink awards…….

I nominate:

• Lovely Cece, for being so damn awesome. I can’t explain it any further.
• The divine Ms. Schatzi for kicking back with a vengeance when IVF kicks her ass!
• Sweet Carrie for coping with the heartache of repetitive loss so damn gracefully.
• Mrs Spock, for also showing how to do IF, health-care worker style.
• Juli, for also knowing the pain of an anencephaly loss and unwanted termination.

Is it naughty to also nominate the rest of my entire damn blogroll? You all rock, in my humble opinion.

Protected: Indiana Jones and the Cycle of Doom

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Mind your P’s and Q’s.

Goodness knows I am not a stickler for over-formal manners. Certainly not in the way that, perhaps, my grandparents and their generational ilk would be.

Well (in the case of my grandparents), would have *been* if A) they were still alive, and B) hadn’t in actuality been shamefully un-mannered. My childhood is chock *full* of memories of the powerful olfactory insult created by the exotic combination of dense layers of nicotine and great unwashed-ness.

I don’t really think that a man should wave me through a door first. If they do, I often wonder if it’s simply an excuse to check out my ass. Hell, I get vaguely uncomfortable being offered the only seat on the train, after all I’m neither ill nor pregnant (sigh).

But.

Having said all this, I do think that some small graces should still apply in this ever faster, ruder, dog-eat-dog, technologically evolving world.

I am going to type a small list of deportment-infringing fines for the various ‘ladies’ and ‘gentleman’ I encountered in my travels today. If only I could issue them in reality.

1. The slob chewing gum with his mouth wide open. I don’t care to see how many fillings you need. Your dentist, I am not.

2. The person wearing their sunglasses indoors. You are not a rockstar. Not even close. In actuality, you come off as a prat.

3. The gentleman with his bum half hanging out of his jeans. I don’t want to see the golden arches unless it involves hotcakes. And for the record your cakes, deluded sir, are not hot in the least.

4. The frantic lift button presser. You saw me push it, and yet you convulsively hammered that poor button repetitively, as if it had personally insulted you. Quit it. My button press worked. It doesn’t come any faster for assholes.

5. The multitude of rude people rushing onto the train before I had a chance to get out of the damn carriage at my stop. The train won’t leave any quicker, you pricks.

There.

That’s better.

Bum to you!

Yes, bums.

The kind that you sit on, not the grotty unemployed and unwashed kind that hang out on the street. Today has been somewhat of an, for want of a better expression, extravaganza of ano-genital maladies.

On a Monday, no less. Surely some of them could have waited until at least Tuesday? After all, there aren’t all that many anal conditions that are rapidly dangerous to one’s health. None that spring to mind at the moment, anyway.

The first gentleman (and I use the expression loosely) of the day set the tone for what was to follow.

For some background, I do believe that I have mentioned that I am currently working in a rather socio-economically challenged area. The people are, well, somewhat rough around the edges. They’re all about as blunt as a rusty nail and mostly come with a permanent haze of either booze or nicotine. Sometimes as a bonus they also have body odour so potent it could be registered as a biological weapon.

Anyway, coming back to my gentle introduction to Monday. Limping in, he baldly stated the following to my query as to how I could help him ‘Doctor, I think I’ve got a great big boil between my nuts and my ar$ehole.’

Excellent.

Barely recovered from having examined patient #1′s perineum and reassuring him that there was actually very little boil to see, and certainly nothing worth lancing, I was hit by patient #2. By proxy. Her daughter had an itchy bottom, but was in school and therefore not present in the consultation.

After gently explaining that I would have to visualise the anal region in question to be able to help her daughter, she offered to bring her in after school.

Needless to say, that was bottom #2 of the day.

Bottom #3 belonged to a woman with a history of hemorrhoids and new rectal bleeding.

The final patient, bringing my Monday total of ano-genital complaints to four was a woman who, terrified she had some kind of rampant vulval cancer came to tell me that she had ‘A lump, you know, on my flaps!’

It wasn’t cancer, but I did (with the aid of a diagram) explain the correct terminology for a labia. The poor woman didn’t have a clue.

In conclusion, I have but one request.

Give me boils, itchy bums, pap smears, prostate exams or a good going case of the clap anyday. Just not all at once on a Monday.

The "mask"

Literally.

Yesterday, I had another one of those patients that stick in your mind, long after having sorted out their medical woes. In this case the kind that you’d be forgiven for thinking had sprung, fully formed, from a cartoon depiction of mutton dressed as lamb.

Seriously.

I wasn’t sure if she was in costume or not for the first full ten minutes of the consultation.

Let me attempt to describe the vision that I encountered. A perfectly outlined mouth, drawn jeeeeuuuust outside of her lip-line in a shade jeeeuuuuust too dark. Mwah! The pancake makeup, layered on so thick that it could have doubled as plaster filler. The eyebrows, oh the eyebrows. Two dark brown semicircles pencilled in halfway up her forehead, bearing no anatomical relationship to the sad pancaked-over fuzzy lines representing the last few sad tortured hairs of her real eyebrows.

She was certainly quirky, and absolutely the most oversexed 60 y.o. I’ve seen in a long time.

Mutton dressed as the proverbial lamb doesn’t quite convey the degree of effort this woman had misguidedly placed in her appearance. This woman was three-day-old bbq pork chops, stale ones, dressed as the proverbial. Her “face” probably left a permanent mark on her pillow each night.

It gave the consultation a surreally cartoonish edge to go along with the sexual banter directed at my (male) supervisor.

Anyway, she had in actual fact (rather kindly) turned up to the clinic to have a benign growth removed, and give me suturing practise. She insisted on watching, completely enthralled, for the entire process.

As I was finishing up, feeling a little battered by the sheer force of personality in the room, she asked me if I could do her pap smear and breast exam at her next visit.

I’m not sure whether to be flattered, or just very afraid.

Love That Man.

I don’t talk about how wonderful my husband is nearly enough.

I guess that sometimes I forget that he, too, lost a child and when it happened he had to watch his wife go off to theatre for a very unwanted termination. It must have felt terrible to be powerless to do anything to help.

Being in the medical game as he is (Yes, health care is rather incestuous, I married another medico), it comes as no surprise that eventually he would encounter a situation rather like our own.

It happened yesterday.

I am so proud of him.

One of the cases on the theatre list in the morning was a woman that, at 20 weeks gestation, had just found out her baby was anencephalic. The poor thing was understandably a mess, but had made the decision to end the pregnancy.

My sweet man did not avoid this case, despite the unpleasant familiarity with PBWCLEW.

To the contrary, he went out of his way to make sure that he was involved in her care and did the best damn job he could to make such an awful experience as easy as possible for her.

Did I mention that I love my husband?

I think that I owe him a blowjob for that one.

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You say ‘jump’, I say ‘how high?’.

Apart from when I’m busy being obnoxiously rebellious, I really am the most ridiculously, stupidly, compliant patient. Even when my internal monologue is screaming at me that I know better and really shouldn’t do what I’ve just been told to do, I do it. To the letter, and to my detriment.

Then that internal voice, thwarted (again) in it’s efforts to stop me doing stupid things on other people’s say-so, settles for twisted recrimination. As well as the oh-so-satisfied ‘I told you so’ when the cycle comes to it’s inevitable hemorrhagic end.

Today was no exception. Compliance…tick. Ritual humiliation…absolutely.

As advised by my RE, I called the nurses at my clinic to share the fact that I was currently menstruating.

It feels odd to ring up a bunch of strangers and say ‘Hey, guess what? I got my period today’, but I did it. Because I was told to.

I needn’t have bothered.

I was right. It was totally odd to publicly announce my menstrual fate. The woman on the end of the line seemed somewhat bemused, as if she couldn’t decide whether to pat me on the back, or simply hang up. I got the impression that there was a distinct undercurrent of ‘That’s nice dear, now you can play with the big girls, after you go find a pad and some naprogesic. Don’t forget to wash your hands, either.’.

The upshot? I blush (down the phone), and a kindly stranger tells me to be sure to let the nurse know at my appointment tomorrow. Then she condescendingly tells me that I absolutely ‘Did the right thing, dear, calling in to let us know’. Urgh.

Great. Now I have to find a way to say ‘I’ve got my PERIOD’ in person without feeling like a total fool.

Wish me luck.

Back to the drawing board (literally)

I almost never actually bother to pee-test to see if I’m pregnant. It’s depressing, and I find myself retrieving the damn stick out of the bin hours later, just in case. A girl needs to keep her pride somehow, and bin fishing humiliation is best avoided by not testing in the first place.

The overwhelming odds are that I will not be, after all. Cycle after failed cycle has allowed me to be fairly sure on the matter.With the addition of my Boob-ometer(tm), I really don’t need to test. The negative predictive value (to get all statistical) of absent mastalgia thus far remains an impressive 100%. The positive predictive value (of sore boobies), for the interested, is 50%. Those cycles (two thus far) I think are an intelligent time to expend urine on a stick.

This cycle, however, being our last gasp at the sex thing, I figured what the hell?

You’ll be unsurprised to note that I obtained the following result:

For any of you that might be unfamiliar with the desired look of a pee test, I have created a helpful diagram to show where the problem is:

 

What I would like to see, but don’t, is a second line.

Even under a VERY bright light, holding the test at several optimistic angles and squinting. I admit that I even tried UV (to my shame). But despite my best efforts, there just isn’t anything there to fuel the imagination. That second space, is (if possible) whiter than the rest of the test.

Let me demonstrate (courtesy of Paint) what I would rather see:

 

I would gleefully accept a pink line. It’s not quite traditional, but I’m okay with that.

I would take, albeit with some confusion, a green line….

I would test my vision rather quickly if I got this diseased looking spotty line, but I’d probably tell the Optometrist that I was pregnant.

Hell, for that matter, I don’t need a line. Even a blue bolt line would do. Beggars can’t be choosers.

But no, nothing. How absolutely irritating.Excuse me while I warm up my chequebook. IVF it is.

What’s a girl to do?

There really isn’t much to say about my current (in)fertile status. I am still absolutely, positively, sure that the only ‘in’ I have in my body is infertility and not a busy zygote ‘in’ utero.

On the plus side, since I’m hell-bent on finding a silver lining, my CD 1 is likely to tie in nicely with the intervention that the various nurses, counsellors and account$$ department have prepared for me on Monday. It’ll save me the twenty cents for the phone call, since I can ‘fess up in person. Now doesn’t that sound like fun, discussing IVF whilst cramping furiously and thinking non-stop about my reproductive ineptitude? I can hardly wait.

Additionally, my soon-to-be-strangled husband if-he-keeps-this-behaviour-up is complaining like a whiny two year old about the ICSI. Goodness knows why or how, be he has firmly got it in his head that ICSI = two headed babies.

I pointed out that at least this would mean we’ve averaged *one* head per baby thus far, if we get pregnant, but he didn’t see the funny side.

He wants to do another SA at the same time he banks sperm, you know, just in case enough of the little sods have grown acrosomes since the last crap SA.

Sigh. Men.

Anyway, on to my dilemma.

I had one of those patients yesterday. The type that skulk in to see you (not their usual doctor) at the end of the day and request Benzos. Large amounts.

Internalising the scream of despair, I went through exactly why this man that I DO NOT KNOW needs 50 Valium after allegedly going through the same amount in 3 days (since his appointment with his regular doctor at the practise).

He, at first, flat out denied all knowledge of a recent prescription. When I smoked him out for a liar by showing him the electronic record (thank they deity of your choice we have one!), he claimed to have ‘memory troubles’ and said he must have lost the prescription.

50 Valium will do that to a man’s thinking capacity.

The poor, sad, rather pathetic looking creature in front of me was so very painfully obviously a man with a very long psychiatric history. He radiated depression. The potplant wilted when he entered the room, everything turned grey, and I even think that thunderclouds gathered over our building for the duration of the consultation. I flat out asked him about suicide (because you just *have* to ask those kind of questions to people like this) and he denied it.

Uneasy, I spoke to my supervisor and presented her with my analysis. Either:

A) He’s a massive Benzo abuser and will withdraw furiously and end up in a bad way before his usual doctor can see him in two days, so we should give him the drugs, or

B) He really did lose the prescription, along with his tiny mind (poor man), some time ago, and it would be kind to give him the drugs, or

C) He’s actually planning to wash them all down with a bottle of gin later on this evening, and I’ll be in the paper as the Bad Doctor who enabled a man to kill himself. I probably should NOT give him the drugs.

Talk about a no-win situation.

After discussion with my boss, I documented the denied suicide risk (=legal ass covering) and documented that he had been advised strongly not to lose this prescription and gave him the bloody Valium.

I only hope that he doesn’t top himself.

My apologies.

I didn’t intend to leave you all trapped in this depressing corner of the Internet, sans new anything for so many days.

I just got rather stuck telling people to buzz off to let their cold get better on it’s own, without antibiotics. I swear that some of them look like they’d belt me when I decline to write a prescription. It is for my sake at least, probably a good thing that most people, no matter how rough, don’t routinely hit women, or doctors. Not unless they’re married to them, at least.

Plenty of that palaver goes on in the cheerful burg in which I am currently stationed. I’m aghast at the amount of women who are ‘walking into doors’ or ‘falling down the stairs’ in this particular part of town. Either they’re all fairly careless, or more likely, their charming spouses get a little feisty when under the influence.Sigh.

Reproductively speaking, the Boob-ometer would suggest that no pregnancy is in progress, sadly.

Never mind…..

I think that it’s time….

This post is in honour of our impending ‘graduation’ away from the whole sex=babies connection (how terribly old fashioned) towards a more realistic alternative for the persistently infertile. By ‘realistic’ I mean the following:

• Mastercard-workout + FSH + HCG + My-vagina-and-pubic-hair-grooming-habits-become-a-matter-of-public-record + Let’s-not-forget-the-VNOD* + Helmetless-sperm-so-why-not-really-thump-those-suckers-in-with-ICSI? + Progesterone + A-big-helping-of-f*ck-this-better-work = babie(s)

(As an aside what’s with the whole ‘Priceless’ jag? I feel the pain of all that ‘Priceless’ spending every time I pay the damn bill on that card.)

Up until this point, my husband and I have, rather whimsically, been referring to our more passionate moments as RRM’s, i.e. Rugrat Manufacturing sessions. I am aware that referring to ‘the deed’ in this fashion is completely puke inspiring, but I bet that we’re not the only ones out there to have a corny TLA** for baby-making shags.

In our defence, we coined the term somewhat naively in those heady pre- ‘You mean I have to pay for really crap SA’s?’ days. Oh, the memories. To think that I once drove back from interstate to shag because I had an ovulation predictor turn positive. How droll in retrospect.

I digress somewhat, but clearly this term will no longer do.

I need to come up with a new name for the old horizontal-folk-dance.

After giving much thought to the matter, I’ve come up with the following euphemisms for our semi-optimistic ‘What-the-hell?’ shags.

1. BCB: Base-covering Bonk.
2. JICS: Just-in-case Shag.
3. STHHR: Stranger-things-have-happened Root.
4. PR: Precautionary Root***.
5. MBB: Maybe-baby Bonk.
6. YMYDTFF?: You Mean You Do This For FUN?

I’m open to further suggestions since my best efforts thus far all lack a little je ne sais quoi.

*Vaginal Needle of Doom. Yes, it *does* go up there, it *is*sharp, and yes it *has* to happen. Those lazy eggs of mine aren’t going to conveniently leap into a petri dish of their own accord when mature. I think it’s for the best that I don’t dwell on it too much. Thanks again Cece for the handy abbreviation.

**TLA = three letter abbreviation. Yes, an abbreviation to describe the act of abbreviating. I *am* a nerd.

***Although, upon reflection, I do not think that our ‘activities’ should be bequeathed the same abbreviation used to describe the medical act of shoving a well-gloved finger up a defenceless bottom. We prefer to use the *vagina* and he certainly isn’t gloved. That would defeat the intention of the exercise, after all.

Higly trained? You bet.

I’m absolutely exhausted. My days are all so ridiculously long at the moment that I go home cross eyed and teary with fatigue.

It might be the lack of sleep, but I’m starting to think that the patients are all out to get me. After all, for what other earthly reason would an endless list of women choose to bring their snivelling, snotty, downright contagious five year olds to my clinic?

That’s right, it’s free, because they’re all on benefits.

I have been drawing deeply upon all of the, ahem, extensive medical training my university has provided to diagnose the common cold. At least three times a day.

To settle this once and for all, and for the record, this is my Public Service Announcement on the matter:

• It doesn’t take five years at medical school to spot a cold. Surprising, but true.
• The average lay-person can do it perfectly well with only a little imagination.
• The signs are relatively easy to identify. Most people get the hang of it fairly quickly. Past personal experience is helpful. Be on the lookout for a sore throat and snotty nose.
• A helpful clue, if you need it to really cinch the diagnosis, lies in your other children having just had the same damn thing. Or their mates in creche, or school, or whatever. Kids share snot. Half of them eat it, ferchrissakes. Don’t tell me that your saintly spawn is the exception. They had their finger up their nose digging for gold walking into the consultation room. I find the credibility of such statements questionable in that sort of context.
• For the reasons above, except in exceptional cases, I have complete faith in your judgement. Please don’t bring your child in just to confirm what you already know. I don’t want to catch it.
• Finally, and I really hope this part gets through, colds are caused by viruses. Viruses are not the same as bacteria. Antibiotics are spectacularly unsuccessful at killing viruses. Yes, I’m very sure about that point. No, you can’t have some because sod’s law dictates that your impressively nasally-discharging offspring will be the one that gets the rampant shits from them. And then we’re both up a certain creek without a paddle.

Apart from that it’s been quite a good week. I just have to hope that I didn’t catch scabies of the woman that has had them for the last five freaking months.

I don’t see how this could possibly go wrong

After much discussion, my husband and I have developed a fool proof algorithm for IVF. We feel confidant that, with a comprehensive plan like this, success is inevitable.

Do you think they’ll let us out of our counselling session early for this one? I think we have the major endpoints covered, after all.