The miracles of modern medicine

I grimaced a little a week or so ago when I realised how old I am now. Then I put it in context. I am lucky to be here, to be this old, even though it is not old at all in the context of our life expectancies these days. But after two ectopic pregnancies and a hysterectomy (without which I was bleeding to death), the only reason I am still here is the miracle of modern medicine. If I'd been born 100 years ago, I might well have been dead three times over.  Or more, because I'm not counting the things I have been inoculated against.  Or  the illnesses I have prevented by wearing long sleeves and sunscreen and insect repellent!

Of course, I'm not alone in this.  It got me thinking about how many of my family and friends have also had medical interventions we just take for granted these days.  Without these, I wouldn't still have my husband, his parents, my sisters, my mother, my littlest niece, my sister-in-law, at least one brother-in-law, and many good friends, not least all those who had emergency surgery for ectopics. Of course, any infertility blog knows that there are many important children in our lives now who would never have made an appearance without modern medicine.  

My mother is struggling at the moment, and we're hoping her current treatment will prolong and improve her quality of life. But she had this cancer 28 years ago, and it has only just returned. She has enjoyed most of those 28 years and we've had her for so much longer than we would have had without modern medicine.   I'm out of town this week, supporting her through her radiation therapy, and writing this in advance, hoping it will go well.

It is all a good reminder to appreciate what we have, when we have it.  And to remember how lucky we are to live in these times and this place.

Gifts of Infertility Series - #12 – Strength

Infertility is really hard. I think any of us who have been through it would agree. We go through stress, endure pressure from family and friends (often unwitting), society, and ourselves, we deal with month after month of disappointment, we have to find resources – physical, emotional, and maybe financial – that we didn’t know we had to cope with this. We feel broken, damaged, and lose confidence. We grieve. We cry a lot. A lot! We feel weak. Yet so often, we endure all this and put on a bright face to the world.

Whether our infertility journey ends with children or not, we have come through one of life’s major stresses. Research has shown that the stress associated with fertility treatment can be at a level comparable to the stress associated with serious illness. But unlike a serious illness, we often go through this without much support, sometimes feeling ashamed or embarrassed.

The grief born of infertility and loss helped me – ultimately - understand just how strong I was. The only problem is that I didn’t realise it at the time! Strength to me is not finding something easy that we breeze through. (Just as it isn’t brave to jump off a cliff if you aren’t scared.) Strength is finding something hard, but still facing up to it, working through it, living with it day in and day out. Even when we don’t want to. Strength is accepting that life doesn’t always deliver what we want or expect.

Strength too is learning how to ask for help. That’s perhaps another post, but I feel it deserves to be here too.

When my father died, a few years after we had ended our fertility journey, I actually realised what a gift I had been given. I wrote then that my infertility and loss experiences

“helped me get through this. … But having been through my (ectopics) and - my biggest loss - learning I would not have children, I knew that I would get through this. And so the grieving did not scare me, in the way I thought it would. Crying did not scare me - so I was the teary one of the daughters, though often laughing at the same time.”

 “My losses gave me yet another wonderful gift, one for which I am very grateful, and that was the gift of being able to help my mother, to focus on her through such a difficult time.”

Grief is horrible, painful, and it can feel relentless. But I know now I can get through it, even when I wonder why I should continue. Strength is not being afraid to lose, not being afraid of grief, because the having, the love, the hope – they are all worth going through that pain. The strength I have as a result of my losses gave me the courage to face a life I didn’t choose. The strength I have as a result of my losses and living a life I didn’t choose now gives me the courage to face up to whatever might come – including inevitably more grief in life. For that, I am thankful.

Gifts of Infertility Series - #10 – Accepting my mortality

When I had my first ectopic pregnancy, I realised that – if I had had this decades earlier, or with a different, less vigilant, less suspicious GP who might have misdiagnosed me – then I might have died. If I had been living a century earlier, I would almost certainly have died. When I had my second ectopic pregnancy, the doctors were concerned that, because of the location of my pregnancy, if it grew too large and ruptured, I could/would bleed out before I could get to the hospital. So I was hospitalised for a week. During that time, the doctors suspected I might have a pregnancy-related cancer - choriocarcinoma - also known as trophoblastic disease. A few months later, during a surgery to remove the last of the pregnancy tissue, there was still a risk that I might bleed out, as I had developed a new, large vein. A nurse helpfully told me how nervous my surgeon was about the surgery, and how many bags of blood he had ordered. (In the end he cancelled the surgery, opting for another procedure first, to reduce the risk of haemorrhage).

On the ectopic site, we frequently told women suspected of or diagnosed with ectopic pregnancy who were displaying concerning symptoms that they needed to ensure that they were not left alone. Collapse and bleeding out was always a possibility. Many women are rushed to hospital for emergency surgery with an ectopic pregnancy. They are often later told by their surgeons that they were “lucky,” even though they didn't feel lucky at all, and that they were only an hour away from dying. (Later, they will often report PTSD-like symptoms.)

One of the reasons ectopic pregnancy (or other serious pregnancy-related or gynaecological conditions) can be so traumatic is that, for many of us, it is the first time we have had a serious health condition, often our first time in hospital, our first surgeries, and our first potentially fatal condition. Sometimes it hits us straight away, and sometimes we don’t react to the reality of this till later, depending how we've dealt with the competing grief and immediacy of a loss of a pregnancy. Each time I was told of the dangers of my condition, I was more upset about the lost pregnancy and the fact that these continuing issues might put an end to attempts to conceive, than about the dangers to my life. It didn't seem possible that pregnancy could kill me - not in the 21st century!

But in due course, it is possible to reflect. I had been lucky. I didn't die, though I could have. Good health care meant that I was fine.  But I had come face to face with my own mortality. I realised that my previous lucky good health didn't protect me or guarantee freedom from danger in the future. I had been on the wrong side of the odds – 1 in 400,000 (for the particular type of ectopic I had the second time) – and so suddenly, being that “one” seemed very possible. I realised that I faced danger everywhere in life. Initially it made the world a scary place.

But after some time, it also made the world a place to be treasured, a place full of wonders, and much love. I realised that – beyond limiting extreme risk - I can’t control my mortality. I'm okay with that. Maybe it is because I realised that if I can’t control it, there’s no point in worrying about it. There's a freedom to this realisation. Death will come to me when it does, and all I can do is live, and live well, in the meantime.

This is my last will and testament ...

Being of sound mind and body ... okay, as a 48 year old woman, I accept that I am neither of these, but I know I need to make this declaration soon.  I've been thinking about making a new Will for a long time.  It is already well overdue.  My husband and I made our Wills in 1990, just before we left to live in Thailand for three years.  We were young, and relatively impoverished at the time.  Our Wills were simple.  Twenty years later, we have yet to update these Wills.  We don't have children of course, and this means that we haven't felt the urgency.  (Mind you, I know of people with children who don't have Wills either.  They're just in denial.)

I probably have stronger feelings about what I would like to have in my Will than my husband does.  I'd like to ensure we have a deal, that if I go before him, in his Will he honours some of my wishes, and vice versa.   We had a cheery chat at a cafe on Saturday about what we'd put in our Wills.  Bear in mind that we're not wealthy, but we do own a house, and have some investments.  We're hoping to use them to fund a long and healthy retirement, of course, but after hearing some shocking and sad news about one of my husband's younger relatives on the weekend, we are suddenly reminded that life can end in the blink of an eye, or the buck of a horse.

Of course, Wills aren't something people talk about much, except for the occasional comment along the lines of "yes, I must make/update my Will soon!"  And so it's hard to know what most people do.  I expect that most people leave their worldly goods to their partners and then their children.  But of course, those of us who don't have children don't have that option.  And I, for one, would like to know that my estate makes a difference to someone when I die.  (The whole issue of death for people with no kids is another - or many other - posts). I wonder if people with children contemplate the same thing?   I know my parents (well, now just my mother), and my husband's parents, are pleased to be able to leave anything they have to their children.  That's what they worked for all their lives, they say, and I can understand that.  I guess multi-millionaires might have a greater quandary.  A well-known NZ businessman has commented that he made his millions himself, and he took great satisfaction from that, and so he wants his children to earn their money too. So apparently he's leaving them nothing, though I suspect that his idea of nothing is a few million each - you know, pocket money! 

Anyway, the point I'm getting to is that we need to make a new Will.  And that because we don't have kids, we need to be a bit creative in terms of who gets what.

I want to leave money to the Ectopic Pregnancy Trust, a charity that is very dear to my heart, despite being based in the UK (they were the first on-line community I ever joined).  They save women's lives (literally) and sanity every day, and they do it on the smell of an oily rag.  I can't do much to help them from New Zealand, but they deserve to be helped, to have some of the pressure taken off them, so they can continue helping women from all around the world .

We don't have that many children in our lives.  Nieces and nephews from my husband's side all live overseas, and are all from prosperous families. Nieces on my side are all grown, except for lovely CJ of course.  But I have a great-nephew (my sister, the grandmother, thinks being a great-aunt sounds so much worse than being a grandmother - I of course, disagree!).  His parents are not well off, and I think an education fund for him would be useful.  Education these days is much more expensive than when I went to university (I was paid to go!), and if I can help him that would be great.  A trust, to assist with the education of any of my nieces' future children, would be a good idea. That came to us over eggs and bacon and a nice pinot gris.

I've often said I'd like to arrange for an AFS scholarship (the student exchange I went on when I was 17) for a student from my old High School.  That's something I would still like to do I think, and would need some arranging.

There are some well-known medical research agencies in New Zealand, and my husband would be keen to leave some money to them too.  Not that our paltry amounts would mean much, but hopefully it would help.

And of course, there are the charities that are important to us or those we love, such as cancer, cystic fibrosis and arthritis.  Yes, we're running out of money.  We realised this even before we'd ordered our latte and hot chocolate.

Then of course we need to leave our belongings to people who would appreciate them.  We are not blind here though - we accept that what is special to us won't be special to anyone else.  We love our things - our teapot bought in the Atlas Mountains, the Vietnamese painting or the African wall hanging - because of the memories.  Others don't share those memories, and so the value of these possessions dies with us.  We're not overly sentimental about this.  The only thing I worry about is my great-grandmother's piano.  I want it to be loved and treasured, in the way that I love and treasure it.   I have just realised that I wrote about it here, mentioning this same concern over two years ago.

And - as my husband jokes - we mustn't forget  the Cats' Home.

We'll sort out executors/Trustees later.  That'll be another can of worms. 

Where did I come from?

I’ve always been mildly interested in genealogy.  Growing up I knew that I had Welsh, Scottish and Irish ancestry, with a bit of Prussian and French thrown in as well.  I’ve shown interest when cousins or others have put together family trees, especially when it involved discovering towns back in the old country where my ancestors came from, all those years ago.  But I've never researched genealogy myself, always thinking it could be something I could do in my retirement, as I've watched my father-in-law do.

And then we learned with finality that we would never have children of our own.  It became starkly obvious, as my father-in-law developed the family tree in more and more detail, that we were the branch that went nowhere, that we had little or no significance on my husband's family tree.  Any discussions about it were painful.  As it became more and more detailed  - showing additions of the latest generation, of cousin's children's children - we felt left behind and even more insignificant.  The actual illustration of the tree showed in graphic terms our branch that was going nowhere.  We could be erased from the tree and it would make no difference.  Of course my father-in-law is oblivious, and thinks we are fascinated to learn about all these new additions to the family.  He enjoys looking forward, thinking about the new branches on those trees, the people coming behind him.  Those with children (and grandchildren) have no idea of the pain that a family tree with a stunted branch - our branch - can give those of us who are childless not by choice.

When my father died, some of the knowledge of my own family went with him.  Since then, his sister (the repository of much extended family information) has also died, and now my mother's memory is failing, and I know there will be things about my family that I will never know.   The words "too late" now have real meaning, and I find that very sad.  But then I become quite callous.  I remember my father, and the stories he told me, and the way he told them.  These are what is important.  Does it matter that I don't know much more?  After all, I have no-one to pass on these stories to.  Perhaps I can just wash my hands of all this?  

(And to be honest - and potentially controversial I know - I always find family trees slightly replusive for the fact that at the top, there are always just two people, but dozens fill the bottom of the tree.)

 

Then last year, my husband and I were considering a visit to Ireland or Scotland.  My enthusiasm for genealogy was briefly rekindled (until the trip was cancelled).  I wanted to know more, so that we could visit with a little knowledge, a little awareness of where I came from, so that we could visit places with relevance to my history.  Thinking about where I come from, where my parents' parents' grandparents came from, fascinates me.   As a keen traveller, I have often reflected on the bravery of my ancestors, setting out to a country as far away from them as anywhere on Earth, saying goodbye to family and friends forever, to establish a new life in an unknown environment.  I'd like to see where they started their journeys.  So I've decided to contact a cousin who is researching my mother's side of the family.  (Ironically, she is also childless).  I know that as long as I can look back, and not forward, I can handle genealogy.  Just don't ask me to keep an up-to-date family tree.