Diagnosis Confirmed and Perspective

It was 2 long days before returning to Parkside to get the verdict from the Neurologist. Dad had called me back from his ski holiday where I had located him the week before, enjoying a round of Vin Chaud in Les Gets in the Alps when I had called. Mum and Dad were enjoying their ‘silver ski’ holiday package including guiding, excellent food, and pristine conditions that morning.

“Your mother is skiing marvellously” Dad had said. “Just like her old self”.

Thank goodness for that I thought, as I imagined that her surgeon would have been quite non-plussed if she’d jarred her knee replacement skiing carelessly over moguls. I had emailed Dad the scanned report from Dr Clifton, and it turns out that their group is made up of other retried medics, and of course a pre-eminent vascular surgeon is also in the party and he would confer with Dad pre dinner.

So when Dad called me back post Cornwall, it was not just his opinion, but the collective view of the ski party that he was returning.

“We’re all confident the MRI will confirm a body tumour - It won’t be an aneurysm – that’s too unlikely for a woman of your age.”

“Oh”, I said, “but Dr Clifton seems to lean towards an aneurysm?”

“No not at all” Dad had said. “Read the phrase again - the report is simply saying that he cannot exclude an anuerysm. That doesn’t mean it is, he’s just covering himself. A body tumour is still far more likely.”

“Ok, well, let’s see” I replied. Not wholly convinced.

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Thursday 7th February finally comes around; it is Alex’s birthday and the date of our deferred appointment with Dr Al Memar.
As we sit down, the charming Egyptian Hercule Poirot has returned:

“Mr Orme, I am pleased to share with you that your wife has a very large and beautiful brain, look at the image on this scan”.

I am put slightly more at ease by his positive opening tone, but essentially my fear boils down to two worse case scenarios:

(a) The MRI is inconclusive and the Neuro team determine that they cannot wait to do an angiogram to conclude, or

(b) An aneurysm is confirmed and the risk is such that they need to operate urgently.

If either of those scenarios plays out, I cannot see a good outcome for my 22 week bump. I’ve resolved that I can deal with anything else.

“Has the MRI confirmed what it is?” I ask

“Yes” He replied. The MRI shows that it is….

And in the same way that when I’m sitting in the main stand at Anfield, I chant ‘LIVERPOOL, LIVERPOOL over and over in my head at the exact same time that the away fans begin chanting ‘and it’s Arsernallll, Arsenal is it… I do this because I believe that if I don’t and I hear the name of the opposition, it will be bad luck and we will most likely lose the match. So as we sit in Al Memar’s room, I am uttering loudly in my head ‘Body tumour, Body tumour, BODY TUMOUR’, but his lips aren’t pursing for a B, instead he opens his mouth and clearly enunciates: ‘AN ANEURYSM’.

And my mouth went dry.

In my mind’s eye I see the Japanese report probabilities flash up like the final score on the display at the end of the match.

But Dr Al Memar is seizing the momentum and starts drawing a useful diagram of the carotid artery, with a balloon like shape branching off to the side of the inter cranial artery just above the fork.

“There is some good news”, Dr Al Memar is saying. “The aneurysm has a very wide neck and we believe it is patent (minimal / negligible clotting). He explains that this means that the risk of clotting building up in the balloon like shape and the aneurysm rupturing is currently very low, aside from the unpredictable effect of pregnancy hormones on the blood.” He continued:

“I have spent some time discussing your case with our team at St Georges, and we are all in agreement that we should wait until after you have had your baby. The best thing you can do is not to worry. You must focus and enjoy your baby first, and then we will arrange the angiogram and the operation”

The dialogue continues until we leave the room with a clear plan and feeling genuinely reassured. Dr Al Memar will call the Obstetrician and request I have a C Section to avoid the pressure of labour, I should take an aspirin every day to mitigate the chances of blood clotting, and we will arrange for the angiogram scan in 4 to 6 weeks after labour.

I call my Dad on the way home to let him absorb the details and then we head to the Duke’s Head on the river in Putney for a reflective Birthday lunch, inhaling some relative sighs of relief.

And for the first time in 3 weeks, I feel at peace, and sleep found me promptly after the 10 O Clock news that night.

Unfortunately our peace and sleep were shattered dramatically at 2.30 am when our room filled with flashing lights and a cacophony of sirens. 2 large fire engines, a large police van and an ambulance were first on the scene to try to control the smouldering flames of a house, 5 doors up on the left from our window. It had formally been a highly presentable 4 floor Victorian house, but the fireman would spend the next 4 hours battling to control the flames of a smouldering mass with two huge hose pipes. Alex was crouched up against the window like a small child watching Fireman Sam, providing me with sporadic updates until Barnaby joined us at 6am. The following day we would observe a scene from Silent Witness as white plastic suited characters would enter and leave the charred remains with their clipboards. One of Nick Clegg’s police guards who stands around the clock on the corner of our road, would confirm that the house had been gutted and a body had been found under suspicious circumstances.

As Alex had watched on, I lay there resigned to the fact that sleep would be hopeless, and tried to piece together how on earth 2 best friends could have the bizarre coincidence of discovering aneurysms in their cranial arteries in their 30’s. Dr Al Memar had described my aneurysm as ‘dissected’ with the prognosis that it was highly likely to be a result of a physical trauma to the neck in my past, akin to experiencing severe whiplash after a car crash. But I have never been in a car crash. So I challenged myself to think about whether it really could be just a coincidence or was there a physical incident that bound Lucy and I together. Could it have been the near fatal 12 to 15 foot wave that had crushed both of our backs and surf boards in the unforgiving surf at Puerto Escondido on Zictella Playa (translated as 'Beach of the dead') at the start of our Central American adventure in 1999.

As the scene got busier outside the window, I lay there recalling the feeling of my back snapping like a twig as I had given up with the struggle of finding the water’s surface for breath. When air bubbles did arrive, I had not even attempted to move my arms, but instead let the waves eventually beach me. With a sand- dimpled face, and a torn leash around my wrist I had found Lucy in a similar splayed position, holding her leash frayed hand to her back in similar distress. We had both been struck completely dumb with shock, and it was only after several rounds of medicinal Tequila that night, that our voice boxes had returned and we able to recount the experience.

Note the photo at the top was taken a few hours before our surf at Zicotella.

The weakness is this theory is that it was the middle of our spines (where I would later have a burst disc diagnosed on my only previous MRI) rather than our heads that had felt the impact of the wave’s power. So the only other link I can think of is the fact that we have both separately climbed high altitude peaks in our early thirties, being led on each altitude ascent far too quickly. For Lucy it was Kilimanjaro, and for me it was the lesser known peak of ‘Mardi Himal’ in the Himalayas. We both have described experiencing the ill effects of Hypoxia (oxygen shortage) on our descents and I have researched somewhere online that there is a higher prevalence of aneurysms in people who live at altitude.

But of course we will never know the cause!

Lucy King's Story

It was almost 2 years earlier in August 2011, when we received a very concerning email from Lucy’s mum - Bridget, explaining Lucy’s precarious situation in a Nairobi hospital. It would be 2 tortuous weeks later when Lucy was able to explain her horrific ordeal in person to Jo Priestley and myself when we went to visit her pre- Op in the ‘Hospital for Neurology and Neurosurgery’ in Queens Square. For Lucy the Queen’s Square hospital was the equivalent sanctuary as the Watergate Bay Hotel was to me. Despite the fact that she lay there on a busy ward, under the most inappropriate fluorescent lighting for a room full of people awaiting neurosurgery. No matter that detail, she was in London, England, home of the NHS and the best expertise in the world to address the terrifyingly urgent situation of a ruptured ‘post cerebral fusiform aneurysm’, and she had risked her life getting there.

After the neurological team in London had studied her scan after the angiogram, their feedback was that they had only seen a hemorrhage like that on a post mortem before, and as they prepared her for theatre, the Neuro Surgeon warned her that at best, she would probably lose her sight on her right hand side as a result of the operation.

The description of events that led to Lucy walking into a hospital in Nairobi partially sighted will always bring me out in goose bumps:

She had been studying and working with elephants in Kenya for several years, and at the time was the Chief Operating Officer for The Save the Elephants charity, spending most of her time in Samburu National Park. She described suffering an extraordinary migraine for 3 days before she raised the alarm for help. Her words were actually ‘A HEADACHE OF NOTE!”

On day 1, the headache was building like it had never done before, and on day 2 she was aware of losing peripheral vision on the right hand side of each eye. She was just about to put her hand up and seek help, when several shouting Kenyan rangers came running into camp, waving their arms in the air and shouting “poachers, poachers, come, come”.

Caught in migrainous confusion, unable to make a rational decision, Lucy King, as COO of Save the Elephants, didn’t feel she could put up her hand at that moment and complain of a headache. Instead she took the driving seat of her Land Rover and in convoy with her boss, she drove 6 rangers deep into the bush to discover the enormous corpse of ‘Khadija’ her beloved Matriarch Elephant and leader of the so called ‘Swahili’ group. Later they would go still deeper into the bush to find Khadija’s calf in the same predicament. With the noise of intense shouting, and faced with cameras in her own face, Lucy might have welcomed death at that moment too.

Instead, she somehow navigated back to camp without the benefit of her peripheral vision and with her splitting headache. The next morning she described her spine as ‘aching’ and her headache too severe to try to stand by herself. Clutching at her mobile phone she called her boss to say she needed to get to a Nairobi hospital that day and she needed help.

Dr Ian Douglas Hamilton has probably done more than anyone on this planet to save the plight of the African elephant, but on this particular morning his attention turned to getting his prodigy safely to Nairobi. He dispatched someone to get her dressed and upright, and arranged for the light airplane that had just arrived on the little airstrip at Samburu, to wait for Lucy and take her back to Nairobi. He was aware of another member of staff – Gemma, attending a hospital that day with symptoms of giardia. So he advised Lucy to head for that same hospital so that Gemma could be on hand.

Lucy remembers lying flat across 2 seats on the small aircraft shielding the light from her eyes. She called her boyfriend Pierre on arrival, incoherently attempting to explain that she needed him and naming the hospital that she was heading to. By fate, she recognised the cab driver at the airport, who would kindly return to the hospital later to drop off her luggage that she had neglected in the cab when she had arrived at the hospital.

Suitably concerned, Pierre, after struggling to understand her speech, had immediately caught a flight from Malindi. On arrival, he would locate Lucy lying in a ‘proper African ward’, full of women dying around her. He was horrified and quickly arranged for a private room, chasing the team for results of a CT scan, which would reveal a ‘large blob’ at the back of her skull. He called Lucy’s mum in Eastbourne, who raised the alarm with Lucy’s closest friends and family, and got herself to Nairobi the next day.

Whilst Nairobi was a better place to be than Samburu, they simply didn’t have the medical expertise in Kenya to properly diagnose or fix the problem, and it was determined that they had to get Lucy to either Cape Town or London urgently. Days would be lost when the MRI discs showed up in London blank, and the Nairobi hospital administrative office was then closed for 3 days. Somehow team Lucy would keep their nerve and push through every barrier that came their way, though at a frustrating African pace. Finally 2 weeks after walking into that hospital, Lucy was taking up 9 Kenyan Airways seats, strapped to a stretcher, with a Doctor and her mum accompanying her on the flight to London Heathrow. After advice from my Dad, Lucy’s sister Sarah had raised the necessary paperwork with Lucy’s UK registered GP, to enable a smooth transition from Heathrow and into the Neuro Hospital in Queens Square.

On tenter hooks, we received confirmation from Bridget that the operation appeared to have been successful, and that Lucy had confirmed that she could see when she came round. As will be the case with my operation, she needed to spend 24 to 48 hours in intensive care, lying perfectly still to enable things to set in place. In Lucy’s case, the ‘thing’ was a sort of super glue that had been injected intravenously into her groin and by a remarkable endovascular method had got to the back of her brain. It would set to seal the aneurysm, blocking out the artery entirely. Given the surprise news that Lucy had confirmed she could see, the doctors concluded that capillaries had grown around the artery to step in and perform the artery’s job to supply crucial oxygen and blood to that compartment of the brain.

After 24 hours in intensive care where she was woken hourly to be monitored, Lucy had her darkest post op moment: The nurses had raised the angle of the bed slightly towards the upright position and left the room. When Lucy opened her eyes, she realised with terror that she had lost her sight and hit the panic button. The medical team rushed back and lowered her once more which joyfully had the effect of bringing her vision back.

Lucy’s situation had been beyond traumatic and precarious, and she would need to take some time to recover at her mum’s flat in
Eastbourne before returning to Kenya after her heroic medical team gave her the all clear.

Present Day and Perspective

Yesterday was another beautiful summer’s day. In the morning I saw the midwife who confirmed that all was well, that Monty has a very strong heartbeat, and on prodding my tum she confirmed ‘this is no Tiddler’. At lunch time I got through to Lucy on the phone to play back my recollection of the facts of her story, and after the call I spent a glorious afternoon on the river bank in Richmond with Barnaby and friends. Before going to bed we found our new Cornish home that we have named ‘Wave Watch’ is now advertised on the Pure Cornwall website for rentals in July. We’ll feel even better when it is complete!

Back to lunch time, and Lucy answered her mobile on the second ring, having just arrived at a guest house on the edge of Tsavo National Park. She was tired after an 8 hour drive to her next field trip, but buzzing from her sister’s wedding last weekend on the shores of Lake Naivasha. She of course wished me luck for Monday, tuned into our timings, given we have already asked her to be God mother to our impending arrival.

Lucy’s insight from her experience has been incredibly useful to me after confirmation of my aneurysm, especially when she called me back from camp in February, providing much needed context to my google research:

“What decade was the research covering” She’d checked. I’d recalled it was 1987 to 1997.

“Brilliant” she had replied. Almost all the data you can find on line pre-dates 1997. That’s when they started to introduce the new endovascular procedures which tend to be safer and more successful than open surgery which is often deployed as a secondary measure. She had learned that in reality the survival probability is much higher than the data suggests, there just aren’t enough cases to bear that out statistically yet.

The perspective I have from Lucy’s story is not so much that she survived completely against the odds, but the way in which she has responded since the trauma:. As she recovered in her mum’s flat in Eastbourne, slowly improving her sight each day and rebuilding her confidence to go for walks outside again; she began to read large print, and started to write an abridged synopses of her PHD on ‘Elephants and Bees’to apply for a prestigious award. 2 months later after an MRI confirmed that the operation had indeed been successful, she also learned that day that she had won the UN prize for the best PHD thesis, the cheque and award for which she would need to collect in Norway later that year. It had been a good day for Dr King, and we found a link to her prize winning story on the home page of the BBC website. You can also see her smiling face on the current front cover of the Biology Journal.

Whilst grateful to all that England had given her, Lucy would return back to Kenya, fully acknowledging the place as her home, and moving into a wonderful house with Pierre and their dog on the outskirts of Nairobi. She still represents Save The Elephants today, but soon after returning she resigned from her role as COO recognising the position to be putting her health under too much stress. Instead she has turned her full focus to implementing the findings of her PHD - Essentially she helps farming communities across multiple countries in Africa to roll out win-win programmes to install bee hive fences employed to protect the farmer’s crops from elephant raids and at the same time providing farmers with the much needed extra income of honey production. (Her experiments had proved that the African honey bee is a natural deterrent to elephants). It is a brilliant model, and her charismatic presentations and evocative videos and media footage have propelled her to win every award she has entered across Europe since - funding her work and a rather comfortable upgraded Land Rover. If you are not already linked to Lucy, you should go to her website www.elephantsandbees to track her progress.

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My intention in writing this blog was not at all to solicit concern or sympathy, as I feel humbled by others who face far greater traumas in their lives. I just wanted to enjoy writing the story and I truly feel incredibly lucky:

I feel lucky because we conceived in a matter of weeks after first visiting the GP. I feel lucky because of the amazing cast of doctors, nurses and radiologists involved in my case, they have freakishly made the discovery of an aneurysm, doubtless years before it might have developed into a really dangerous situation like Lucy’s had. With the diagnosis confirmed, my delivery can be well managed and I’m in a great position to be fixed. I feel lucky that I have such a close family on hand to support me, including parents who can be both mum and dad, and doctors to advise. I feel lucky that I can always draw on amazing friends both old and new, and that both my husband and son are so happy natured. I also couldn’t be happier going forward,if a successful operation allows me to say goodbye to future migraines, as has been the case for Lucy.

Perspective also comes from feeling humbled by other people’s strength in their periods of sustained adversity: I can draw on my sister as a role model – she juggles being the most amazing mother to her 2 beautiful boys, with fortnightly treatments, and regular scans to deal with her terminal cancer. She is courageous, and so far, the success of her treatment and continued good health is in itself a remarkable story against the odds.

I am also particularly humbled by the strength showed by our great Dutch friends in Putney – The Trommels - who last year, arguably found themselves in the most traumatic situation that anyone could ever face. Just skimming the surface, here is my insight of Froukje and Bastiaan’s story in 2012. Alex and I like to refer to them as 'The Dutchies’:

The Dutchies Story

We had picked up their daughter Famke from nursery that day, (Famke is best friends with Barnaby having been adorable playmates since their birth 2 weeks apart in early 2010). When Famke woke up in our spare room, we had the great honour of telling her the wonderful news that she now had a little baby sister called Karlijn. But within hours of breaking the happy news, it was discovered that she had been born with a rare liver condition and Froukje and Karlijn would have to be transferred by ambulance from Kingston to Kings Hospital in Camberwell.

As long as I live, I will never forget my coming together with Froukje in an atrium on the ground floor of Kings Hospital one day later. Embracing in a hug, she let out the loudest and deepest whale of aching pain that I could ever imagine, it seemed to echo throughout the entire hospital building. I thought the window panes might crack and minutes later with her still trembling, I finally pushed her back to see her face and softly asked:

“Is she still with us?”

“Yes” Froukje confirmed “Just!

Please come to the ward and meet her”.

2 weeks later I would be looking on at the doorway of Bastiaan and Froukje’s tiny hospital bedroom along the corridor from the critical care unit. In the cramped space , sitting on each single bed either side of the room, were Bastiaan, Froukje, her mother, father, sister and brother, all of whom had flown over that morning from Holland, when I’d picked them up to bring them into hospital. As they sat there, Froukje started to tell the story of a crushing set back that day as she tried to articulate that she still held the possibility of hope. She shared her belief that it wasn’t over just yet, and that the miracle of the liver transplant that might somehow become available for her 5 lb baby who lay in a tiny cradle on the critical care ward around the corner, still might happen as seconds, minutes and days passed by. And as she spoke through clenched desperate tears, each family member one by one, had hunched over, shoulders beginning to heave in unison with cries of their own. Despite the intensity of the story telling, Froukje, and her brother and sister would look up at me and take it in turns to translate each line of Dutch. As Froukje continued expressing her feelings in two languages, each of us in turn reached out to hold each other’s hands in a circle, crying as one.
Somehow, in a perverse and incredibly strange sort of way, I steel feel privileged to have been there to bear witness to this cramped room filled with family pain, hope and support.

And on a Tuesday morning, 3 weeks after her birth, Karlijn, whose organs were beginning to fail one by one like a pack of cards, was somehow still being kept alive. Froukje called me to tell me the unbelievable news that a suitable liver had turned up a few hours north of London, and their amazing Peruvian Surgeon was accompanying the precious parcel to Kings Hospital after he had operated on the donor to remove it in an operation the night before. Froukje was careful to hold herself back on the phone, and was methodically detailing what lay ahead: The Peruvian Surgeon would need to rest and get some sleep for a few hours on arrival at Kings, and then that night they expected him to embark on what would be a 12 hour operation to insert and stich up the new slice of liver into her tiny fragile body. Froukje and Bastiaan knew the risks were extreme, but finally they had a crumb of genuine credible hope.

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Remarkably today just over one year on, the Trommels are now a happy and positive family of four. I am sure a day doesn’t go by when they don’t feel gratitude towards the donor’s family, or feel relief for the beautiful second daughter that they have. But life at the same time is always going to be quite hard, and only last Sunday, on Froukje’s birthday, Bastiaan had to take Karlijn back into hospital for a few days again, as she had caught a bug. The sort of bug that all babies catch and get over with simple rest, some TV and a spoon or 2 of ‘Calpol’; but The Dutchies cannot take that chance with Karlijn and she will spend a few days recovering in hospital each time. They are also wary that a difficult operation still lies ahead for Karlijn to fully re-stich up her stomach. So despite encouraging steps forward, they also have consistent steps back, disrupting normal daily life and restricting them from taking holidays abroad. Yet they both remain remarkably strong and positive and happy, and an inspiration to their dear friends in Putney.

The Dutchies also have the perspective of the debt they owe to the NHS. Although there were moments at Kings in Camberwell, when they had longed to be at home in Holland with their support network on hand and the comfort of familiarity; they know that had Karlijn been born in Holland or indeed outside of London, she most likely wouldn’t be alive today. So when a giggling Famke, a grinning Karlijn wearing a Union Jack vest and a fantastically happy Bastiaan and Froukje joined us to re-watch the opening ceremony of the Olympics last July after the Olympic road race went past our house; we raised our glasses of champagne to toast the wonderfully choreographed scenes that Danny Boyle had created in tribute to the NHS.

I also thought back to the happy tribute when a letter arrived from Dr Al Memar in February, naming the extensive team of doctors who have studied my scans and will be involved in my own surgery. Dad was fairly chipper when I sent him the letter during the Man-U v Real Match. It was a great evening for him, enjoying the fury of Fergie as his team would unfairly have a man sent off and crash out of Europe; and then receiving a list of 6 names of doctors, 2 of whom he knew of and respected greatly, and the rest of whom he would later satisfy himself, were thee national experts in their field if not internationally. And with that information to hand, there was nothing more in our control left to do, allowing both my parents and I to fully move forward (I hope)from the confirmed diagnosis.

To conclude part 1 of this blog, I’d say that it’s not really about the bloody aneurysm anyway. Like Lucy it is all about how I respond, and if I can continue the start I have made this year to live my life with guts to take similar life affirming decisions and risks in the pursuit of fulfilment and happiness like she has done, than I can continue in this happy and excited vein. Roll on Monday morning!

Links:

https://www.organdonation.nhs.uk/how_to_become_a_donor/registration/registration_form.asp

http://www.elephantsandbees.com/research_project/Welcome.html

http://www.savetheelephants.org/

http://www.purecornwall.co.uk/

http://www.guardian.co.uk/football/2013/mar/05/manchester-united-real-madrid-live-mbm

Portreath

The wind was up that day, buffeting the surf boards against the roof of the car as we screamed down the A30 towards our turn off. When we drove around the final bend into the village of Portreath, we could see the wind whipping up white horses along lines upon lines of surf, breaking from the harbour wall to the right and then traversing westwards across the bay. We turned past the Atlantic Café at the fulcrum of the beach, and parked on Battery Hill which banks up a cliff, above the surf and lifesaver club below. As we stepped out, doors slammed back against us, the chill got inside our anoraks, and sea air seeped into our lungs. Just then the sun broke through from clouds which were starting to retreat from the North Coast for the day,and the village of Portreath which had initially looked grey and tired and yesteryear, sprung teasingly into life. Brilliant winter light danced across her harbour, kissed the ocean below, turning deeps blues into aqua marine wash, playful plumes of spray brushed against dramatic rocks to the left and right and disappeared around the headland and out to sea. Fulmars soared up from the cliff below, surprising us and heckling as if they’d just heard a bad line at the comedy store; and dust quickly started to build up on our car, a nod to the building work behind us.

“I think this is this one”, I said, turning to look up at a large 4 story house set back from the road and into the cliff side.

I’d been looking at a CGI image of this very house every day for the best part of 6 months. In each dull interlude at work between meetings or emails I would find myself on the Chartsedge website – an agency specialising in high end homes in Devon and Cornwall. Despite the price tag, I would be drawn to this particular development, and would check each time if there were any gallery images I had missed on my previous log in. There never were. There was something about the large open plan living space, with floor to ceiling windows providing an uninterrupted panoramic view of the Atlantic thundering in, framed with craggy headlands on either side. And despite the building work being at a fairly early stage, reality was better than any architect’s image, and we could instantly see our dream laid out in front of us. It was every house I had ever coveted.

It was now 11am and we were supposed to be meeting a guy called Barry who was due to show us around at 10:30. The apologetic builders had let us in and given us a hand up each flight of unsafe wooden stairs, as they tried Barry on his mobile once more. We were standing in the master bedroom looking out of a huge window,imagining Barnaby doing sprint training on the beach below, when Barry finally arrived. We turned to see a huge pirate of a man walk in, shoulder length salty blond hair wrapped around his face, huge calves bulging out of long shorts and large feet spilling out of sole-less shoes.

“Sorry I’m late”, he said in his soft Cornish accent.

“I’ve just walked in from St Ives and it always takes longer than you think along the cliff walk, especially in this wind…The surf looks good today though, doesn’t it?”

I was just creasing my forehead thinking about how on earth anyone could do a cliff walk in sockless feet and buckled leather shoes when Alex asked him:

“How far is that then? How long did it take you?”.

Barry replied: “Well I got drunk you see last night in St Ives, and so I couldn’t drive back and I don’t like taking the bus. So I had a few hours kip on a friend’s sofa and then I set off at 6 ish. I think it’s about 21 miles if you follow the cliff walk. Beautiful morning though, beautiful! Bit windy mind!”

And this was our introduction to the enigmatic Barry - the developer and crafter of our dream house. He oozed Cornish warmth, sincerity and unintentionally would have us laughing and smiling in hope for the months to follow. Always slightly evasive on detail:

“How many kids do you have” Alex had asked after we discussed the local primary school in depth.

“Well at any one time there can be up to 10 to 18 people in our house. That’s why I’m going to go for a surf before I go home. I surf every day if I can, 365 days a year. Are those your boards on the roof down there. Do you like surfing then? Is he going to be a surfer? He should join the nippers club. Best surf club in Cornwall that is"

We are sold hook line and sinker, even before he takes us around the completed house next door, where the London owners have set the bar ridiculously high in their tasteful and luxurious fit out. We are reassured by the finish and quality throughout, and Barry confirms they are doing very well with holiday lets.

“Do you like it? We ask Barnaby “Would you like to live here?”

“I want to go back to the hotelllll” replied Barnaby. “I want to go back to the pooool. When can we go back to the pool, I want to go surfing in the poool, nowwww"

He is soon distracted when we go inside the surf shop at the bottom of the hill, and he discovers a large bright red skateboard. “I’m going to be a skate boarder mummy, I’m going to go really, really fast”.

The shop owner agrees that Barnaby may well become a skater if he comes to live here, and he’d be able to show off at the annual body-boarding championships that are held in Portreath each year. Apart from the surfers on display, dare devil skate boarders will come careering down Battery hill sloping round the corner to the beach doing their tricks at break neck speed.

“Looking at one of Barry’s houses are you?”

“Yes – that one there” replies Alex. “Do you know Barry? How many kids does he have?” asks Alex.

“Oh he’s got a few, never any trouble mind, they’re always knackered you see, he walks them everywhere. He makes his 6 year old walk to Hayle and back for lunch across the cliff top there.”

Having talked to a few more welcoming locals, and after checking out the pool at the 5* Gwel an Mor resort above us, we finally give into Barnaby and head back to Watergate. Pointing out the football pitch at the primary school, the BMX tracks off to the left, and wondering what enchanted secrets lie behind the Tehidy Wood gates as we pass.

Inspired by Barry, Alex is quick to unwrap his blue and white striped Local Hero 9 ft 4 longboard and run into the surf on our return, whilst I wrestle with the idea of forcing my wetsuit around my growing bump, but reluctantly give in to common sense. So Barnaby and I retire to the Ocean room with a packet of crisps to watch his daddy dodge kite surfers from our comfy window sofas.

“Is that him, mummy? Is that daddy standing up there, there?”

“Well briefly” I said.

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Sunday is all about Barnaby as it should be. It is his 3rd Birthday which starts dramatically at 5am when we awake to a horrible thud as he falls out of bed, face planting on the unforgiving wooden floor below. We race into his room, and join him in the bunk beds to sooth his face and watch his ‘Father Ted’ box set, marvelling at the educational value of the farmyard mechanics.

Despite the abrupt start, the day washed over us all happily with presents in bed, an enormous breakfast, more surfing and swimming and kite sailing on the sodden beach. Cheeks were filled with burgers and chips and ketchup from the Beach Hut restaurant which sits under Jamie's Fifteen, and we all bathed in the healing powers of Watergate Bay. We would be very sad to say goodbye the next day, but our minds were buzzing with the ethereal image that the Portreath house had presented.

As the iPad provided the Chuggington background noise on the car journey back, my mind had turned back to a profoundly brilliant course I had been on 4 years earlier with my company. The course is known as “The Energy Project”. It sounds entirely cheesy to explain it, but it was one of those courses that cynical attendees alike got something out of. One challenging exercise we had been given on day 3, was a blank piece of paper on which we should draw our dream future – be it the job role, a place or whatever came into mind. I was considering leaving the page blank when I saw that even the CFO was drawing something. So I took hold of my pencil to see what I would draw, and moments later, barely decipherable, I had scribbled an image of myself at a desk, dwarfed by a surf board in a house on a cliff above a surf beach. It had taken me aback at the time when asked about it, as I expected myself to say I wanted to be the CEO one day of a medium sized company, but I forgo the opportunity to show off with my ambition and had articulated that I simply wanted to do a job that would allow me to surf every day, in a location that would inspire the book I still thought I had in me.

I don’t think anyone had taken me seriously, least of all myself. Until that weekend that is, when I was trying to facing up to my own vulnerabiity and had felt I'd glimsed our dream future.

In a similar vein, Alex had never managed to shake off the happy recollections of childhood holidays in St Agnes (just 10 min drive from Portreath) where he would endlessly muck around in rock pools with his Dad, returning to a little cottage in the evening on the corner of ‘Stippy Stappy’ road which is at the top of the hill from Trevanance Cove. We had talked about our ideal destination together, and Alex just wanted to live somewhere safe, where the kids could enjoy the outdoors, get fit and play out their Enid Blighton adventures, far away from the urbanised lure of the video game.

So chatting on the way back, and agreeing to park the small quandary of how we would derive an income in Cornwall, we agreed that we would go for it; and that I would call Miles (the agent) on Tuesday morning and offer him the asking price. In fact before we came off the M5, I had placed that call and left a message for him to call me back.

As I started to put the iphone down, it vibrated back at me. So I took the call excitedly expecting it to be Miles, but instead I was met by Dr Al Memar’s secretary. She was calling to say that Poirot wanted to put the Tuesday appointment back to Thursday in order to more widely confer with his colleagues on Tuesday afternoon. “Has he got the results then”, I asked.

“Yes, I understand he has”. She said.

And the rest of the car journey passed by quite slowly after that.

Confirmed Diagnosis to follow

Cornwall heals

I have learned that when you’re going through a traumatic experience, as was the case for me at the start of the year - then you need to hit a low point, acknowledge it, and then move irreversibly and determinedly forward from it.

As I sit here now in the present tense, on another sunny day enjoying the buzz of the effervescently popular Artisan café in Putney where I write this blog; it is quite hard to evoke the raw emotions and fear that I felt at the start of the year because I have not since returned to those memories. I have moved on completely - focused and excited about our future family of 4, and determined that the life that Alex and I have always dreamed of living, but not quite had the balls to go after, will truly begin after my impending operation.

But for this post, we go back to the first week in February, when my lowest moments came on the evening and the morning after my second MRI whilst travelling on a small plane to Cornwall with Barnaby.

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The second MRI was far less traumatic with a friend on hand, and with the experience of the first, I was able to fix my mind on a point above my head and take long deep metronomic breaths. The session was well choreographed by the radiology manager who had been brought in from St Georges, and would talk to me in between each scan, breaking up my anxiety and getting me to the end quicker.

It was a crazy day looking back – I hadn’t wanted to pull out of an all company presentation that afternoon where 100 or so colleagues would be gathered in an auditorium in Clerkenwell specifically to hear my presentation and take a tour of the new office that I was managing at the time. Having rushed from the MRI room after they had removed my rhino like folds of grey casings around my neck, I quickly got back home to change, and ran from train to taxi to conference centre to lectern, flanked by my powerpoint presentation either side. I would later be satisfied with a job well done and the laughter that I had invoked, but the adrenaline downer on the painful commute home to collect Barnaby and the tension of the day would create the perfect conditions for the back of my neck to clamp shut, and the beginnings of the worst migraine I ever need to endure.

With Alex meeting us for a mini break in Cornwall by a surf board laidened car the next morning, I was without the security of his support to get Barnaby packed and through his bedtime routine that night, and to the airport the next day. But nothing could deter me from my mission to get us both to the sanctuary of the gorgeous Watergate Bay Hotel and the short break that we so desperately needed together as a family. Though looking back, we made it in spite of me, and because of Barnaby’s wonderful compliant behaviour and support. I have never met a toddler who can show such empathy and behave so adorably when I truly need him to.

I try to live my life with few regrets, but I fully regret turning on my laptop that night after I’d got Barnaby to bed. I have not allowed myself to indulge in any negative thinking, nor let the tears properly flow since that night. As a mother, it was entirely irresponsible and unproductive and a place I can’t afford to return to.

On the assumption that I have an aneurysm, my search string quote from Dr Clifton’s report had led me to a Japanese report on a decade of data comprising ~ 100 cases of aneurysm operations with the same characteristics and expected location as my own. It was not a good read! There are seemingly not enough cases in Europe to provide similarly robust statistics. Despite being in a migraine stupor at that time, I can still quote the report verbatim as I did to myself over and over in bed that night, indulgently letting my head run away with the 2 negative scenarios available. I fed my migraine with sobs and tears,preventing me irrepressibly from sleep.

It was Barnaby who got me up at 6am.

“Mummy, is it time to go yet? Is the taxi here? Can we go to Cornwall now? Please mummy? Yes mummy?”

And it was time to get up, and possibly for the first time in his life, Barnaby went back downstairs and got fully dressed into his travelling outfit all by himself, whilst I surveyed the wreckage of my red eyed face and my sore head that had been fed just 30 minutes of sleep.

“Come with me mummy”, Barnaby said as he led me and his Gruffalo Trunky bouncing down the stairs to the front door, where outside the taxi was indeed waiting for us.

I obviously read the signs when we arrived at Gatwick, but I could swear that it was Barnaby who led me to the gate and not the other way round. He loves airports, he loves planes and he loves Cornwall, and I have never known him to be so helpful, well behaved, and completely compliant and good natured on every request. It was as if he sensed that he needed to be in charge that morning.

As we got to the height of our climb, with the small Flybe jet preparing to descend immediately, I placed my hand on my forehead where I could feel the mother of all migraines throbbing in my palm. I could sense that all the blood had drained from my face, and when I closed my eyes I saw the psychedelic lights of a children’s light shaker. It was at that hellish low moment that I thought of my irresponsibility and the possibility that I might black out, leaving Barnaby sat next to me on the back row with no instructions as to what to do with him. Who would know that his Daddy would be meeting him at The Watergate bay hotel if his mummy wasn’t conscious on landing? How had I not even asked the neurologist if it was safe to fly on a short flight that would actually present more air pressure force than a longer one? Damn the knowledge from my degree! Just then Barnaby looked at my glazed over eyes, stopped sucking his lolly and said:

“Is your head poorly again mummy?”

When I nodded, he said “It’s ok mummy, I’m here, let’s look out of the window together, shall we? Yes mummy?”

And we could just make out the toe of Britain, as a shard of winter sunshine crept out from a cloud and shone a torch on turquoise waters lapping the shores of the Lizard Peninsula, with the plane banking northwards towards Newquay. I felt the pressure relief valve open a little at the back of my neck and inhaled a deep breath. .

The second that Alex made it to the hotel after a long car journey, I handed Barnaby over and told him I needed to be in a dark room alone for some time to recover. The boys dutifully trotted off and had a ball in the stunning hotel infinity pool that ends in a huge glass pane looking out over Atlantic rollers that seem to threaten to come right into the pool.

As ever when I need it most, sleep evaded me, but after a few hours of rest I ate some microwaved porridge that I’d bought at Gatwick, sat upright and would later be brought back to life by Barnaby’s unconstrained delight that he had swum the 30m length, aided by arm bands but not by Alex (remarkable given how clingy he normally is in the pool). Alex is beaming too:

“You’ve got to see it for yourself Soph, come, come”.

And so I followed them to the ‘Ocean Room’ lounge where I looked on at Barnaby’s infectious splashing in the pool below and let his squeals of joy wring happily in my ears. Later I would join him in the lovely chlorine free water, and turn to watch the sun setting on the beach through the enormous glass front. I had reflected that if I was given an unlimited budget to design my perfect beach side hotel, I would struggle to conjure up something so perfect as this place.

I was already beginning to feel cleansed, my bad head was retreating, and after 10 or so hours of sleep that night I started to feel human again.

In fact Saturday would be a brilliant day and a turning point, it was actually the day when the nightmare regressed into the background, replaced with the glorious vision of our dream future that still fills my daily thoughts and feels well within our grasp today.

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‘Confirmed Diagnosis’ and ‘Making Plans’ to follow after I've scrubbed the mildew off the Bugaboo from the damp cellar…

The First MRI

Anyone who has been pregnant knows that it is not a great idea to lie rigidly flat and still on your back for 40 minutes whilst your concave bump blocks your eye line as you lean forward. I had had an MRI scan a few years earlier and found it claustrophobic, but time limited and manageable. The ingredients were different then. This time round I was not wholly encased in the chamber but my head and neck were surrounded in layers and layers of casings like a 1940’s deep sea diver. The radiologist handed me headphones, a panic button which I held in my sweaty right palm, and a sort of periscope to see her with. Of the music options on offer, I made an idiotic choice, but no matter - the beauty of the MRI scan is that the music is completely inaudible except for the brief respites in between scans when all you can hear is the sound of your own pulse anyway. Actually in my case I wasn’t sure if it was my pulse or Monty’s – it sounded a hell of lot quicker than the ultrasound had measured it the day before, and I couldn’t distract myself from it for a moment.

‘Is everything OK’ asked the radiologist: “Just 3 scans left – 2 short ones of 3 mins, and 1 long one of 7 minutes and then it will all be over”.

“OK” I replied.

Of course I wasn’t ‘OK’, but I was entirely focused on the finish line and didn’t want anything to delay its arrival. My left leg had just fallen off its position on the bed and since my core muscles were incapable of pulling it back again, I tried to find some kind of meditative psychic state that might coach it upwards and back again. But I couldn’t move it an inch. Maybe I would have been able to if I’d been to any of my pre-natal yoga classes. I would decline the periscope device for the subsequent MRI 2 weeks later, as all it did was focus my thoughts and eyes on the submarine lump in front of me. I had signed the disclaimers before entering the room - something about a theoretical risk to the hearing of the 4 month foetus, and I’m not sure the intense anxiety was doing my blood pressure much good either. As I lay strewn, I thought of all the amazing technological advances that had happened in the last few decades and wondered how on earth nobody had come up with a way to reduce the decibel levels of the MRI. I braced myself once again before the pneumatic drill sound of the MRI gripped my vibrating body in a noise deafening envelope, pummelling of all my senses at once.

Finally it was over and the female radiologist approached me to take off the casings around my head and help me up. Once up right, I felt a dull sensation in my back, and slid off the bed, stumbling to the floor. The radiologist’s assistant swiftly came to my side and supported me with an arm under my shoulder to usher me back to the waiting room. I felt so sorry for the next patient who saw my useless legs shuffling on the floor incapable of coordination. I think I was suffering some kind of temporary paralysis that I would also repeat the next time. It was probably the combination of lying flat and the intense anxiety level that I had never physically felt so acutely before. But save for the inevitable migraine that the MRI had induced, I got over it all very quickly, and was up and walking a few minutes later and back to work that afternoon.

Parkside hospital is ruthlessly efficient at every appointment and every step. The following afternoon I am sat behind the Endocrinologist’s desk being reassured that the tumour identified in my pituitary gland is fairly microscopic and will likely be treated very easily with tablets post breast feeding. He is not at all concerned and I agree to monthly blood tests and follow ups to monitor the hormone balance. So no dramatic surgery required after all and I almost feel a sense of anti-climax. Unfortunately that is not the end of the £150 consultation. Despite reporting on the scans so quickly overnight, the radiologist, with her remarkable diligence has picked up some shadowing on a view of my neck in 1 of the 18 scan views taken. This specific scan sits on the Doctor’s desk, circled in red pen.

“Here you can see shadowing in the artery in your neck. You need to get this checked out with our neurologist here” said the Endo Dr as he brought me to my feet and escorted me swiftly to reception to get an appointment with Dr Al-Memar. I agreed to an appointment offered by the receptionist the following week, but the Endocrinologist questioned if there wasn’t an appointment available that same day. I’m offered 7pm, but decline as Alex is working away and I can’t quickly think of a babysitting option. It’s only as I drive home that I reflect on the apparent urgency that the Doctor was encouraging.

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“Mrs Orme, please sit down here. Now may I firstly remark on what a large and beautiful brain you have. Look at the image on the screen - it is just as it should be. The brain is a beautiful thing”

I am immediately disarmed and charmed by his warm smile and upturned moustache.

Dr Al Memar looks like an Egyptian Hercule Poirot, he is thoughtful, well considered and generally running late. We discuss my migraines for about 20 minutes, which is a huge relief as I had neurotically pushed for such a discussion with an expert for many years, only to never be taken seriously. He draws a diagram to share with Alex:

“It is important that your partner understands the physiology behind the migraine, the recovery cycle and all the potential causes. It can be just as hard for your partner as it is for you to understand and manage”.

This guy is brilliant I think. Better still he says that after the baby is born I should return to see him, and he will prescribe some fantastic high strength new drugs that will ensure the headache never gets to the debilitating stage.
Reassured and fairly relaxed, we finally turn our focus to the shadowing on the MRI and I ask what it could be.

“Good Question” says Poirot. “It looks like you have some kind of obstruction in the ‘right carotid artery’. The two main arteries that supply blood to your brain are in the right and left side of your neck, known as ‘carotid’ arteries.” Again he is drawing. “Your right carotid artery of course supplies the right hand side of the brain which actually controls the left hand side of your body. I believe that the shadowing is a large body tumour (benign), an aneurysm, or actually nothing at all”

“How could it be nothing at all”, I ask.

He responded with the explanation that it could just be a misleading scan showing a multitude of cross sectional vessels overlaid on top of each other to appear like an obstruction. At this stage, our Poirot is leaning towards the ‘something and nothing’ diagnosis as I had confirmed that I don’t faint or black out. However, he explains that we must explore further and he arranges for me to go to a hospital in Cheam, Surrey to see a ‘Dr Clifton’ the following Tuesday. Normally the Neurologist would have arranged a so called ‘angiogram’ and CAT scan which would be conclusive quickly, but the angiogram consists of injecting a radioactive dye into the vascular system which is of course a no-no for a an expectant mother. So he admits that getting a confirmed diagnosis will be tricky, but he conjures up the image of Dr Clifton’s magical neuro-radiology powers. “Clifton is thee expert in the Country and I need his judgement on this”. So Dr Clifton will study my neck with ultrasound equipment, much like the baby is monitored. It is an entirely non-invasive risk free technique. Poirot also assures me that he will not request another MRI until I am at least 6 months pregnant, as he is not comfortable with the risks another scan might present at this stage.

I call my Dad after the appointment and read out the radiologist’s description of the obstruction – 3cm in diameter, ‘ovoid’ in shape and situated at the bifurcation of the right carotid artery’. Dad makes some enquiries and later that day calls me back to say that the thinking is that it is most likely a ‘benign body tumour’ if anything at all.

“More exciting than the prolactinoma, but not a particularly exciting diagnosis, Sophie.”

He explains that a surgeon will need to remove it at some point but points out that the neck is a brilliant healer. “You’ll hardly even have a scar. It could be nothing, as the neurologist says, but it’s unlikely to be an aneurysm as they are so rare.” I felt that the inference was that an aneurysm might tip the scale into the exciting zone.

Once again I appreciated my parents’ fast track medical opinion and network, and more than that my Dad’s vocabulary. I could work with “not particularly exciting” – it brought my hypochondriac thinking back down to earth. The phrase reminded of when I called my Dad up when I was endlessly waiting at A&E to get my cheek bone x-rayed after a lacrosse tackle to my face. Dad had asked me to describe the pain over the phone. “Would you say the pain is exquisite” Dad had asked. I paused at the unexpected adjective, and had to conclude that ‘no – it wasn’t exquisite as such.” So Dad confirmed it couldn’t be broken and I should get myself home, which I did. “No, not broken apparently” I’d reply the next week to my colleagues when I sported my distorted purple right cheekbone.

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My iPhone map led me pretty quickly to St Andrew’s hospital in Cheam. It is no Parkside, with no Times in the waiting room or offer of a Twinning’s tea. I’m quickly called in by the nurse into Dr Clifton’s room where I sit in a dentist like chair waiting for the Dr to return.

“He should be here in a minute”, the nurse says again 30 mins later. We’ve covered all the usual small talk by now – ‘No – I don’t know if it’s a boy or girl’. Yes – I already have a 3 year old who’s a bit naughty to be honest’. ‘I’m actually only just over 4 months pregnant, and no it’s apparently not twins’.

When Dr Clifton arrives, he nonchalantly turns on his machine and bangs the large computer element until it resonates and hums into life. He introduces himself and picks up the Dove like deodorant stick of the ultrasound instrument on a chord and starts rolling it back and forth along the right side of my neck. It sounds very much like the heartbeat of Monty, only slower. After about 10 minutes of rolling and listening to the rhythm of the blood flow I relax and my mind is transported back to my aeronautical engineering studies at University. I’m back at Wills Hall at Bristol and my Z block corridor mates are amusingly doing impressions of Northern Ben who has come through the toilet block corridor from X block.

“Sophie can you help me with my fluids homework”.

Ben’s from Rotherham and very much proud of it, his ‘can you help me with me fluids’ line had sounded much like the Yorkshire boy’s accent in that old milk Acrington Stanley who are they? advert:

“Surrrrphyyyyy, what makes a liiight, light?” “Electricity of course”

And of course the ‘help with me fluids’ phrase also induces some fresher’s year puerile giggling.

The point is that as the ultrasound roller ball travelled up my neck, Dr Clifton was comparing the sound and speed of the blood flow as it navigated around the ovoid obstruction on the right side with the normal direct blood flow expected on the left hand side of my neck. I couldn’t see the information on the screen, but I could hear the difference, and pictured the blood travelling around the object, just like I could see diagrams of distorted air flow around an aerofoil shape in my mind’s eye – creating the lift force responsible for the wonderful concept of flight.

So I had achieved a far better Zen like calm in that room for the 40 minute scan than I had with the MRI, but the repeated rubbing and sensation of feeling the lump had invoked a hideous nerve ending headache which started on the right side of my face and travelled across it to my left ear in sickening fashion that would stay with me for the next 4 days. I have not even tried to touch my neck or locate the lump since that day.

“Can you find anything there” I asked Dr Clifton.

“Yes, most definitely” The Dr replied. I’ll send my report to Dr Al-memar by the morning.

I wouldn’t get to sleep that night ahead of a boisterous Barnaby bundling into our room at 6am the next morning full of 3 year old chatter and questions. I’d looked up images online of tumours and aneurysms at the fork in the carotid artery, and realised that whatever the lump was, it would be wrapped snuggly in a bundle of nerve endings. I thought of my migraines in a different light, and felt nauseous and quite awful at work that day.

On Thursday I would return to see the Egyptian Hercule who was not his cheerful self. Despite his previous comments about MRI risks before 6 months, he would march me back to the x ray department and request a same day MRI. Calls would be placed to St George’s hospital arranging for the right people to attend the MRI that lunch time. With the time I had, I took myself home to grab a sandwich and my laptop and try to call Alex unsuccessfully at work. For me, Dr Clifton was heavily leaning towards the diagnosis of an aneurysm in his report and hence a step up in perceived risk and urgency. I called my old Z block Bristol Uni friend – Felicity, who would likely be at home with her kids in Wimbledon, and asked her to find a way to join me back at Parkside in an hour. I didn’t really fill her in except to say that I needed an MRI at Parkside that lunch time and it hadn’t gone well when I had one 2 weeks earlier. Felic is an old friend, and without needing further explanation, she juggled what she needed to and arrived one hour later with a sleeping Ciara in the pram, ready to hold my hand through whatever it was I was I about to embark on.

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The post ‘Cornwall Heals’ will follow when it has written itself shortly, no contractions pending.

The First Diagnosis

It seems bizarre looking back, that on the eve of Alex’s Birthday on the 6th February this year, I stayed awake praying that the neurologist would confirm a 3cm body tumour in the right artery in my neck. I don’t suppose many people pray for a diagnosis of a tumour, least of all those like me whose family is horribly familiar with the count and measurement of the myriad of cancerous tumours that my sister lives with and so far have successfully been treated every 2 weeks. But in my case, if it were to be a body tumour than it would almost certainly be benign, and the surgery to remove it, whilst sounding crude (incision from collar bone to chin), would be pretty much risk free and without urgency. The alternative diagnosis or an inconclusive diagnosis at 5 months pregnant didn’t seem to bear thinking about.

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If not desperation, than a daily longing for a brother or sister for Barnaby propelled me to see the GP that day in August, together with increasingly frequent migraines that were becoming intolerable.

12 months earlier, I had said to a friend that whatever would be, with be. We were so content with Barnaby, that I would be reluctant to go down the medical intervention route (IVF) if we found it difficult to conceive again. I’d rather focus on the half full glass, rather than the gap of the brother or sister we’d always presume would come along. But weeks turned into months, and then a year to 18 months passed by of unsuccessful ‘ trying’. I don’t know about Alex, but I got to the point where the desire for another child became burning, and on the days when my period finally came I felt empty and desolate.

It was the first time I had seen Dr Helm – she was not my regular GP and was just filling in at the practise that day, luckily for me. My medical parents would later marvel that she made a connection with my migraines and irregular cycle and sent me off for a blood test to measure the hormone ‘prolactin . It was inspired pattern recognition and she would later be vindicated in her assertion that I might have a small tumour in my pituitary gland next to my brain – potentially causing the head aches, and certainly causing a hormone imbalance which had led to the irregular periods, decreasing our chances to conceive. Dr Helm referred me to an ‘Endocrinologist’ who I saw privately in Wimbledon. Endocrinologists are a funny breed of doctor, focusing entirely on the endocrine and all the biochemical cues that glands react to, in order to fire off different doses of hormones in the body. Endo Doctors provide rational explanations to some of those women who blame mood swings, or weight gain, or fatigue on ‘hormones’. It turns out that sometimes those women are right. In my case, an over production of prolactin was mimicking the effect of breast feeding, and at the same time suppressing my oestrogen production and disrupting my cycle. It turns out that I could have turned on the milk tap at any time, months and years after stopping breast feeding Barnaby. Interestingly, my body would have been sniffing out any fat in my diet and storing it up for a rich bit of milk, leading to an un naturally high body fat content. So when this diagnosis came, it was with some relief, as I had found it so difficult to fully lose the podgy weight I’d been carrying since Barnaby’s birth.

The Doctor wanted me to have an MRI to study the pituitary gland, and if it were a ‘prolactinoma’ then there would be a good chance that its size and affect could be reduced with tablets, failing that radiotherapy, and failing that surgery.
In the mean-time he suggested I lose some weight to give the oestrogen a better chance of winning the battle against the prolactin. I can’t say that I wasn’t offended in my female defensive way, by his suggestion that I needed to lose weight – and damn it - I’d just been vindicated in my challenge with weight loss, but he was suggesting that if I wanted to conceive I needed to try harder. I had always found dieting had never worked for me, and had taken the increased exercise route each time, but with the motivation of increasing our chances of having no. 2 – I invested in a ‘G.I’ diet book on the good Doc’s advice, and would spend the next month craving carbs.

Within 2 weeks, my late period came, and after a month I was still battling with the daily sense of starvation and lack of energy. In parallel I had been in continual correspondence and phone ranting with my medical insurers who had refused to sanction the MRI on the grounds that the GP had mentioned the word ‘fertility’ which is the first excuse a medical insurer can latch onto as exempt from cover. With help from both the GP and the Endocrinologist and my refusal to accept their conclusion based on my parents assurance that the insurers were wrong - I finally got the concession I needed to go ahead with the MRI.

But 5 weeks had passed since the intended MRI, and when I came to fill out the paperwork in the X ray department I realised that I couldn’t confirm with 100% certainty that I wasn’t pregnant – as I determined that there was the improbable chance of conception 2 days earlier.

I put my valuables in a locker, entered the room with the flat bed in the centre, the metallic chamber around it and the window panel to the radiology team in front. The radiologist came in and I admitted the minute possibility of pregnancy. She said that if it were her, than she wouldn’t go ahead and risk it – yes, even if the foetus was just 2 days in creation. She told me to come back when I was absolutely sure I wasn’t pregnant, or if I was, it would be safer in my second trimester.

I was so frustrated, as I just wanted to go ahead with the MRI. Now I might have to wait for up to another 3 months for my period if it were irregular again. I reasoned that I couldn’t trust a negative pregnancy test, as it had been wrong several times with Barnaby.

A few weeks later I would feel the surging emotions of relief and exhilarated happiness when I came running down the stairs to breakfast holding up the plastic pen to Alex above my head saying “it’s positive, it’s positive, it’s positive, we’re having another baby, it was also not lost on me that I could stop the GI diet right there and then. Barnaby had mimicked me, saying “yey- we’re having a baby, it’s positive”. Alex kissed me on the cheek, lifted me up in the kitchen and we then checked ourselves hoping that Barnaby wouldn’t repeat his new dance and line to anyone else.

Happiness coursed through my body for the next few weeks and months like an impenetrable shield to stress at work, the migraines (which eased off in the first trimester) and morning sickness. I felt driven, happy, complete. Every day for the first month of our knowing and not sharing it with others, I would punch the air and say ‘yes’ to myself and to the sky on my morning walk to the station. We couldn’t have felt more contented as a family. I had of course no idea of what would lay ahead in January, when the first MRI not only confirmed the presence of the pituitary tumour, but would point to a much more concerning shadow in my brain’s vascular supply.