24/06/2020

I have puppy brain! I can’t concentrate on anything as I always have Frank in the back of my mind. Where is he? What’s he chewing on? Has he done a wee? Has he done a poo? When does he need to eat? Am I training him right? Is his tail waggy enough?

As you can probably tell, he is a fantastic distraction. All consuming. I have a newfound respect for anyone who has trained a dog, or better, a human.

Since Tom and I left London, I have started the fertility treatment. We came away from the last appointment with injections and tablets for me to take in the morning and at night. Tom does the injections for me as I can’t face it, which is ironic considering my job.

As they only have one chance to collect as many eggs as possible, I have been put on double the normal dose of hormones usually given to stimulate the follicles. This puts me at risk of something called Ovarian Hyperstimulation Syndrome. I’ve been warned to watch out for the symptoms as it can be potentially serious.

Ovarian Hyperstimulation Syndrome is a complication of fertility treatment and is an exaggerated response to injected hormones. Symptoms include:

● Mild OHSS – mild abdominal swelling, discomfort and nausea

● Moderate OHSS – symptoms of mild OHSS, but the swelling is worse because of fluid build-up in the abdomen. This can cause abdominal pain and vomiting.

● Severe OHSS – symptoms of moderate OHSS with extreme thirst and dehydration. You may only pass small amounts of urine. You may experience difficulty breathing because of fluid in your chest. A serious, but rare, complication is formation of a blood clot in the legs or lungs. The symptoms of this are a swollen, tender leg or pain in your chest and breathlessness.

It all sounds horrible but luckily the only side effects I have been feeling are stomach cramps. The worst thing so far about being on this treatment is that I have to go into the clinic for regular monitoring.

Tom and I have been travelling down from Bakewell to London to attend the fertility clinic. At each appointment I have a scan and a blood test.

So far it has been bad news that I am not responding as well as they had hoped to the treatment, despite being on the double dose! Apparently there may be residual hormones left over from my contraceptive implant, which has now been removed, that are suppressing the follicles from growing. It is extremely frustrating to hear that this could delay me starting my chemotherapy.

I feel annoyed that I wasn’t advised sooner to get the implant removed. I’m not sure if I have the right to be annoyed, or who I am annoyed at. It just seems so logical that they should have told me when I got my diagnosis: if I was even considering going through fertility treatment, I should remove any source of exogenous hormones as they may interfere with treatment.

The fertility doctor told me not to worry if I have to start my chemotherapy the day after egg collection, but I think that is most definitely easier said than done. The egg collection will be done under deep IV sedation (not quite general anaesthetic, but close). I imagine I will be feeling pretty rough afterwards and probably won’t be in the best condition to start chemo the following day.

When I vocalised these feelings, the fertility nurse told me not to worry because “it wouldn’t be a problem to push my chemotherapy start date back a week.” This too did not fill me with joy. I feel as though I have waited long enough now to get started and I feel anxious to begin. I don’t like being told not to worry, especially about things like when I will start potentially life-saving treatment.

I hope more than anything that they tell me at the next appointment I am ready for egg collection and that I can start my chemotherapy next week without delay. More likely is that they tell us we have to push everything back a week and I will be in the same position this time next week.

Plan:

– egg collection as soon as possible

– start chemotherapy

– teach Frank to roll over, stay, paw