The parenting series

Part one: It might not happen as quick as anticipated….

Photo by Dominika Roseclay on Pexels.com

This is a series I have been thinking of doing. Inspired by multitudes of my patients and addressing some issues that are related to the parenting journey in general… I am hoping that the upcoming little snippets of the journey to parenting, some very personal to me, shine a light on a topic that is rarely talked about in normal conversation. All those struggling with fertility or struggling with parenthood, just know that I see you and hope by normalising the conversation you can stop hiding your own struggles and feel open to talking to your GP.

Part 1: It might not happen as quick as anticipated…

It was a lovely weekday when Rebecca* and Sam* arrived for their appointment. They were a lovely young couple in their late twenties, and they had jumped through all the adulting milestones and were ready to be parents. Except, it was not happening which understandably was frustrating for them. They had got married, bought their house, got their large family car, and updated their health insurance for the upcoming stork delivery but it seemed the stork had the wrong address.

With the unrelenting questions of “when are you having babies?” from friends and family they had finally decided to come and see me for some assistance.

We started unpacking their presentation. They had already downloaded some apps to track her ovulation and they would have sex every day at the times when the app was saying and despite that, it was now 6 months later, and they were over the disappointment that came with the monthly period.

This was an easy one, or at least there was still room to move before we needed to refer them for specialist intervention.

First, we discussed that at their age they had 30% chance of falling pregnant with every cycle which is always interesting as most people tend to think the chances of conception are very high. Sure, if they were 16, they could have sneezed* and had an unplanned and unwanted pregnancy but usually when pregnancy is wanted, it does not always seem to follow the script as required.

Also, given their age and relative health, they were technically allowed to try for about 12 months in total before we started to investigate for medical issues that might be the cause of their difficulty in getting impregnated.

Additionally, although the ovulation apps let you know then the ovum/egg is released from the ovary, if you think of how small a sperm is and how far it must go to meet the sperm, it makes sense that if there is no sperm already at the end of the tube waiting for the egg to be released, you are already too late. Having said that, going at It like rabbits is not likely to help either as the amount of sperm in the semen is likely to reduce with time.

So as the consultation continued, I could sense their relief there were remedies we could trial before they were officially “sick”. First, they were to use the ovulation information they already knew but start the horizontal dance twice during the week and once on the weekend from about 5 days prior to ovulation until at least 5 days after the egg left the ovary. That would hopefully bring back the fun of doing the dance but also hopefully the reduced frequency will mean the concentration of sperm is maintained in the semen increasing the chances of getting knocked up. 

They left my consultation room looking more hopeful than when they arrived with some homework to consider. A few months later, Rebecca arrived with smiles beaming. She had peed on a stick and saw 2 lines…

*not real names or real patients

PS: remember that this blog entry does not constitute medical advice. If you have any questions of a medical nature, contact your nearest medical facility for help.

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The day endometriosis nearly killed me…

I woke up with the most excruciating pain and large volume, sudden onset vomiting. The time was probably a little before midnight as I staggered to my parents’ bedroom to let mum know I wasn’t feeling all too well. As mum is a sympathetic vomiter, i.e vomits when she sees anyone else’s vomit, she kindly advised me to try and small sips of water and she would try to get the floors clean. I had to sit in the lounge room, covered with a little blanket as I tried to deduce what could have made me so violently unwell. I recalled the day well. I had been to school and been home without anything eventful. Dinner was a non-event either and the following day was another school day. Every small sip of water or milk seemed to increase the pain in my tummy and before long I was vomiting again. Mum, although not a doctor, diagnosed a simple case of gastro and told me to try and sleep it off.

After a lot more vomits, the spilled contents gradually changed from food to bilious green and eventually coffee grounds colour with flecks of blood. Only on seeing the blood did mum think it wasn’t’ “gala” (gastrointestinal imbalance) and thought best we presented to the hospital. By now it had been a few hours of ongoing vomiting with me feeling completely weak and unable to walk. We quickly drove to Gaborone Private hospital, as I cried in the back seat, urging her to drive through red lights as the pain was most excruciating. On arrival, almost passing out from the pain, I was immediately sent off for surgery to manage a bleeding peptic ulcer. I remember telling the doctor in charge how much I loved him for the morphine and anti-vomiting medication he had administered.

I was 15 years old at the time and used to having severe debilitating period pains that would often make me miss a few days of school each month. I had had my period the day prior to being unwell, and not trying to miss school again, had inadvertently taken an overdose of ibuprofen to manage the pain and had caused myself to have a bleeding ulcer. My mum and I thought that severe period pains were “normal” aspect of being female and even on post-op follow up with my GP I was informed that having excruciating period pains was an accepted part of being a female.

It wasn’t until being a medical student and having ongoing issues that I was eventually diagnosed with endometriosis. On reflection, I was able to realise that I had suffered and almost died from self-medication of this condition without ever having a diagnosis. I was made to feel that, like labour pains, there is a lot of discomfort that comes with being a female when in fact this is very far from “normal”.

Let my lived experience act as a cautionary tale that not all period pain is created the same. So educate yourself about the condition, there is plenty of information on reputable medical sites and present to your doctor if you have any suspicions that you might have this condition. Like Emma the yellow wiggle let those of us who are 1in 10 illustrate that endometriosis can be managed to some extent and, although it has no cure, it doesn’t have to define who you are.

Other sites to look up

Jean Hailes Website