I'm aware that it's been some years since my previous medblr list and previous medblr roll call posts. Over the years we've built a thriving and supportive medblr community, which we've been really lucky to have. I'm using medblr in the widest sense, here - nurses, PAs, pharmacists abd all sorts of other professions are welcome.
Years have passed. Many of us have continued to live offline lives or post less frequently because work, kids, other interests and just life got in the way. Some have changed specialties. I know that there have been years I've been fairly quiet because life was busy! But even if you post infrequently, youre still a valued part of the community. Please feel free to reblog and add yourself to the list.
Some left the sphere of medicine, that's cool too - if you ever identified as a medblr, there's still a place for you here.
New medblr friends have joined - why not introduce yourselves? It would be great to make some new connections in this sphere.
I'm also curious about non medblrs who lurk here for fun.
I'll start first. I'm @dxmedstudent (she/her, late 30s), I also go by Tink (that predates my blog here and is somewhat unrelated). I started my blog here over 10 years ago when I was a UK med student writing med student comics which can still be found over at @dxmedicalstudent .
I spent some years in hospital medicine before becoming a GP this past summer. I haven't changed my name or icons in that time so if you think you remember me, you're probably right.
Lovely to meet you all, and to say hi to old friends.
There's a move towards self advocacy and ensuring patients can ask midwives, nurses and doctors why they are being offered interventions. This is not inherently a bad thing. There are times when things are rushed or staff behave sub optimally.
The world is big, and midwives, nurses and doctors could sometimes communicate better and do do better. Because mistakes happen, each patient and relative should be prepared to advocate when they are worried about something. They should want to understand their care. Sometimes treatment *is* bad; we know in the UK that maternity care has gotten worse (and in terms of mortality we are still significantly better than the US despite the concerns here). Birth trauma is real and outcomes for WOC especially black women are worse. Discrimination in healthcare is real. We do know birthing people have experienced pressure or even assault (as treatment without consent ) when it comes to interventions during birth. Working in healthcare, we all know that sometimes things get messed up so I'm not goung to downplay that.
Many of the issues relate to underfunding, lack of resources and poor staffing as well as time pressure, like in the rest of the healthcare service. Like Biokitty says, treating staff badly is also likely to affect care as it's harder for people to support you as best as they can if you are hostile to working with them. It strongly helps if you are open to listening to them and making a plan together.
There's also a trend by influencers to push beyond self advocacy into this idea that you automatically know best. That your "body knows how to do this" so you shouldn't need medical help. Which is actually harmful when our bodies *do* need help and can make people who needed help to labor or feed feel broken and inferior. Especially given parenthood can end up feeling like competing rival cults when it comes to birthing or feeding choices.
There are people out there profiting by spreading a belief that you know the right course of action intuitively, and things will almost never go wrong (it'll never happen to you, obviously!) and that healthcare professionals are generally dumb, overly intervening and lazy or even cruel. That we are maliciously and selfishly pushing interventions to make their lives easier, or to profit, and that what you *really* need is to ignore medical advice and trust your body. And often, to pay an influencer to give you their unqualified recommendations instead. And then you can be a good mom who fits in their birth goddess club because she birthed the right way. And in their club, everything is organic and "natural" because all modern interventions are bad and full of chemicals.
They'll say that babies survived before modern medicine so you can totally choose to ignore all your midwife and obstetrician 's advice and it will be fine. Trust your body. My mate Sandra did it and it went great!
Except as we've seen after investigation into the Freebirth movement, these sentiments have cost birthing parents and babies their lives.
Declining vitamin K has no real benefits but has cost babies their lives.
So I think a lot of it probably comes from the deliberate and active erosion of trust in medical professionals in general but especially around birth, stoked by influencers who profit from setting themselves up as a clean, natural, holistic alternative (for a price), and from the people who follow them and then spread those beliefs.
My previous personal updates were about starting the IVF process this summer. Abd well, you can't exactly go on holiday mid IVF cycle so it's been a tame summer from that perspective. We've gone away once or twice with friends for a weekend, but we've not really had the time to plan a longer break.
Injecting yourself with medication daily is a little taxing - it can feel like your social life revolves around making time for it, and my facial skin still hasn't recovered from the hormonal onslaught. But it still felt a lot better than waiting for treatment, because it felt like it was doing something to help.
Egg retrieval was nerve racking, especially after my cat nearly died from an anesthetic complications a couple of weeks prior! And then it was a tense week or so of watching the embryos and hoping that not too many of them don't fertilise or stop developing.
We learned that we had a few embryos that seemed good to use, and we transferred one, with a plan to freeze the rest for future attempts, as is standard. A lot of hopes have rested on those microscopic bunches of cells.
We tried to keep our expectations realistic, because this process can be so emotionally taxing. On average it takes 3 euploid embryo transfers to achieve a clinical pregnancy with IVF, and our NHS centre doesn't do PGT-A testing so we had no idea whether our embryo had the right number of chromosomes to sustain life.
I was already mentally planning the next cycles, whilst DxDude was telling me you try not to worry too much and that the first cycle might work, in which case we wouldn't need to plan cycles 1 or 2 months ahead.
And I'm not going to lie, being this lucky felt like a shock. It didn't feel real for a while, even after the 7 week scan with my fertility team. Even 14 weeks in, I still feel like I'm going to find out that it's been some kind of elaborate misunderstanding and I'm actually just very gassy!
The wait to find out felt like a long time...but it was a success!
A close friend of mine developed severe pregnancy complications soon after I found out, and she delivered her micropreemie not long after. And to be honest I was so worried for her and her baby that I really didn't have the space to worry over my own pregnancy at all for a while. She and baby are doing really well now, and it's been a joy seeing them progress. I can't wait to see the rest of her journey into parenthood, she's already tge best mama 🥹.
Despite a smooth first few weeks, the end of the first trimester was rough on me, and I needed some time off work as I felt too unwell to even get to work let alone be a functional clinician. I'm really lucky, I didnt need a cocktail of drugs or hospitalisation, but I did need quite a lot of rest. I was super keen to get back to work ASAP but I'm glad my wise and experienced GP was firm and a little intimidating. She definitely helped me to put myself first.
I've only just gotten back to work recently, and whilst the nausea (and awful food aversion) and dizziness is a lot less, it's been replaced with pelvic pain, which isn't necessarily more enjoyable.
We've had our 12 week scan and combined testing, which has come back as low risk - which is a relief.
Knowing if your baby is likely to have Downs is useful, because there are many serious health issues that people with Downs syndrome can face, and with the right support and early treatment, they can have a good quality of life.
Needless to say, I'm still 100% for parents having the option to talk things through with their team and terminate for medical reasons at any stage of a pregnancy, sadly serious conditions can often be discovered late in pregnancy.
But as a doc, my main concern was Edwards and Patau syndrome, because these are severely life limiting conditions, with most foetuses not surviving pregnancy let alone infancy. I've seen what severe genetic diseases can do to children and families; I still think of those families today, more than a decade later.
I'm still worried that future tests will show up something rare and serious, all I can do is hope they will develop OK and without suffering. It's hard not to feel pre-emptively worried, but I'm trying not to let that get in the way of enjoying what we have now.
From the perspective of my health, I think I'm ok? My fibroids are now much bigger due to pregnancy hormones, which will mean more monitoring later on, and I'm due an appointment with the obstetrician. It also means I already look pretty pregnant tbh and have had to overhaul my wardrobe, so it felt kind of awkward not telling people close to us when it was hardly subtle!
I'm a summer child, so we told my parents when I went to celebrate my birthday with them, which was pretty early. I wasn't well enough to attend the face to face meeting with my MIL that we wanted to tell her during, and we told her on another occasion. We started telling friends slowly on a case by case basis; big social media announcements aren't our thing.
Funnily enough, work (or some people at work) had to know almost immediately because I should be kept away from seeing infectious patients who could have chickenpox, measles etc. when possible. When I had to take sick leave, I let the partners know, because I respect them and really do think they care. Work have been supportive and I feel really lucky. I didn't feel like it should be a secret, but I also didn't really have the reserve to go round telling everyone when I felt sick, either. I feel bad that our lovely receptionists were worried sick until they heard I and baby were OK, I wish I hadn't worried anyone. One of them is already knitting us something for the baby, which is amazing.
Choosing when to share is hard - I'm very pro sharing as early as possible, especially given how taxing early pregnancy can be, and how common early miscarriage is. But sharing can also be tiring in its own way.
Enjoy the meme I sent DxDude after our egg retrieval.
We had a good number of eggs and most of them have fertilised! They are now chilling out and growing for 3 days and we shall see how many of them develop well. It's normal for a degree of attrition at each stage, so I've warned DxDude that we may not get many blastocyst that are healthy enough to implant this coming week.
This is precisely why the aim is to collect as many eggs as reasonably and safely possible. It's strange how full of hope and promises a few tiny cells can be, I'm really hoping they develop well, if only you could psychically spur on your peetri dish children to flourish! I have a lot of feels about them, and I really hope we can get enough healthy blastocysts out of this cycle to have a baby - though I know there is a good chance that may not happen, but they will be loved even if they perish along the way.
I may update you guys with more numbers, but I think I'd like to see how things develop first.
We were offered standard IVF or ICSI - though as they felt that icsi wasn't needed we opted to let them mingle organically to see how well they would fertilise. The difficult thing is that on your first cycle, you have no idea how you'll respond to medication or what the problem is and whether ICSI would help. If we end up having more rounds, we will hopefully have an idea of what has not worked.
The procedure itself went smoothly. I got the good stuff for pain relief, and what they say about propofol is true, it burns! Alfentanil made me feel sort of drunk. I also got a diclofenac PR that I was very grateful for - given that I effectively had a knitting needle repeatedly punched into my swollen ovaries via my vagina. I'm sharing this specifically because there's justified concern around women historically receiving inadequate pain relief for procedures. I'm still a little sore days later, but it's not too bad.
The staff were lovely and I was pleasantly surprised that nearly all of them were women. Of course I wouldn't care if they were male, but it's interesting how big and diverse the team of people working with you are. We saw plenty of nurses and ODPs, multiple embryologists, an andrologist, an anaesthetist and a fertility specialist just for this one procedure, not counting the appointments that I've had prior (many nurses, multiple specialists, pharmacists, ultrasonographers, receptionists etc).
There's something kind of lovely about a big team of people working together to help you make a family. It might be a lonely journey at times, but it's nice to know we are not alone.
A lot of people don't really know what to say when discussing infertility, and a lot of people who are struggling with it complain that people say hurtful or triggering things to them - often unintentionally.
So I thought I'd write a guide about what not to say, taken , unfortunatelyfrom hearing or seeing people express these opinions:
You just need to relax/get drunk/go on holiday/not stress so much/not want it so much.
Telling someone to be more relaxed or less stressed doesn't work - kind of like telling someone to calm them down doesn't, in fact, calm them down. It also minimises the fact that a lot of people with fertility problems have actual medical problems causing the situation, which may require treatment or might even be untreatable.
It also comes with the (likely unintentional) implication that it's your fault for not conceiving because unlike everyone else, you're just not relaxing enough. You fail at relaxing. You're doing trying wrong.
So you can't have kids? Like, at all?
Putting aside that it is a little insensitive to say this, technically infertility means that a couple tried to have kids for a year or more but were unsuccessful. Infertility is reduced fertility, and sometimes the term subfertity is seen as more accurate.
People can be told that they have a condition that affects fertility like fibroids, PCOS or endometriosis, but they may still conceive if having unprotected PIV sex and should still use contraception if they do not wish to get pregnant.
This is also why folks on T and folks on oestrogen/progesterone HRT should talk to their team about contraception, whether they are cis or trans. Whilst taking HRT can sometimes reduce fertility it does NOT render you sterile and people often need to use an additional contraceptive.
Sterility means being completely unable to have kids - for example, if you have had both gonads removed.
Infertile couples can sometimes eventually have children unassisted, and most infertile couples manage to conceive with fertility treatment.
Have you tried having sex/tracking ovulation/insert absolutely beginner knowledge here)?
Oh crap, we've been mistakenly putting it up the ass this entire time! Silly me!
Unless you're the couple's doctor and your job is to walk them through every possible issue and make sure nothing is missed, please assume that they have done their research and have the basic stuff down. Treat people as if they are sensible and competent. Believe people when they say there is a problem. Leave the diagnosing to their fertility team.
Because when you think about it, if a couple have been trying for like 3 years and you ask them if they've tried LH strips, it's kind of patronising.
You didn't become an expert just because you accidentally got pregnant 5 years ago or conceived first try with your second. People who have been struggling with a health problem for years have usually done a ton of reading, speaking to healthcare professionals and lots of tests - they almost certainly know a lot more than you about it.
Oh yeah, I know how you feel! I've been trying for 2 months / hope to have kids and I'm terrified of being infertile, I couldn't stand that. It would ruin my life!
There's a place for sharing your concerns, but please don't expect people suffering a condition to have to console you about how bad it would be for you to live their life. Infertile people don't want to hear that their life is your worst nightmare, it's just a rude thing to tell someone.
Don't tell people with coeliac you'd die if you couldn't eat pasta, don't tell people who are blind that you'd end yourself if you couldn't paint or watch TV. Just ... have some tact.
Ha, being a parent is hard, are you sure you want that? Would you take one of mine?
No, Debra.
Please stop making light of someone's personal grief or disability. This is like making boomer "I hate my wife" jokes to someone who just lost their spouse.
But what do I say, then? I don't know what to say!
I've legitimately seen people say the most insensitive thinfs and then turn around to say this.
But...
You don't have to say anything- believe it or not you don't have to offer an opinion or advice on sonething you know nothing about. They aren't waiting on YOU to fix their problem or give them advice on something a team of specialists hasn't been able to fix.
If someone tells you that they are having fertility issues, just tell them you're sorry to hear that and that you hope it works for them soon. Or ask them if they want to talk about it and let them know you are there to listen.
More things not to say after the cut...
My friend's aunt's cousin was about to have infertility treatment, then they just had twins! I'm sure that will happen for you, when you stop trying!
Everyone tells us their one in a million "miracle stories"... but they just aren't fun to hear, for many people with infertility. They may give some people hope, but they can make people feel even more isolated and unlucky because we KNOW how unlikely it is that we'll have that same luck.
Also for most of us, stopping trying would make actually conceiving and carrying to term extremely unlikely. Please don't discourage people from seeking medical help when they need it.
Well I don't think IVF/using a donor/single parent families/lgbtq families is right/natural.
It's great that you don't need it and don't have to have it, then! But your opinion is kind of irrelevant to everyone else.
Lots of modern medicine isn't natural - and as a doctor, I REALLY don't think "naturalness" or your personal comfort level with a treatment you are completely ignorant about is a relevant metric for how beneficial a medical treatment is to the people who need it.
We've spent all of human civilisation working to give us more tools (and better ones) to help people. IVF is a tool. It's an accommodation for a disability or inability due to circumstances that lets some people overcome their medical conditions or circumstances.
Are you saying that to cancer patients? To people wearing a cast for their broken arm? To people wearing a prosthesis for their amputated leg? I absolutely hope not. Please do not do that.
Other people's medical treatments are between them and their clinicians. If you don't like it? You're free to not have said treatment. If you don't want kids, you are free to not have any. I'm a passionate advocate for access to reproductive care, contraception and abortion.
But if you're pro abortion, you cannot meaningfully be anti-fertility treatment. Because you either believe in bodily autonomy or you don't. You can't pick and choose only when it benefits you.
I just think that if you can't have kids naturally, then your body/nother nature/God is telling you something and you should just stop trying. Maybe your genes are just bad and shouldn't be spread. Maybe you just wouldn't make a great parent.
Look, nature is stupid. It gives kids type 1 diabetes and genetic conditions that kill them in infancy and gives your loved ones cancer. Do you go around telling everyone that they should just due or accept being permanently seriously ill or disabled because nature gave them an illness? Do you refuse all modern medicine because you should be listening to nature's plan for your body? I bloody well hope not, because that's dumb when modern medicine exists.
There are all sorts of dumb reasons why people are infertile - why would having a tube blocked by endometriosis or slow sperm make someone a bad parent? Why are you literally telling someone to their face, whose meducal problems you dont even understand, that you think they are just too defective to make a family?
Let's stay away from the eugenics, shall we? We could have a nuanced conversation about how genetic testing of embryos can potentially reduce or eliminate rare fatal diseases which kill children and have no hope of a life without significant suffering. And how most couples who have IVF successfully go on to have healthy chikdren who live normal lives. But no, Steve, stopping your mate with a mild varicocele from having children is not going to revolutionise the human race or fulfil some alternate divine fate.
Well, fertility is a first world problem, some people have real problems, we should be focusing on that instead.
Actually, it's a problem for millions of peole, around the world. The IVF industry is huge in certain parts of the Global south, for example India.
People think it's a white rich people problem because most of the people who can afford to undergo fertility treatment privately or adopt...are the wealthy. But it's always been a problem - that affects people across cultures, socioeconomic groups and sexualities. And infertility has often been accompanied with shame and ostracisation. Stigmatising fertility care hurts everyone. Especially the poor.
Many LGBTQ couples need fertility care - whether because their gender affirming surgery or HRT or health complicates things, or they and their partner's combination of gametes makes things tricky. Making fertility care less taboo and more accessible helps them too. The conversation very often side tracks and ignores them but their struggle is valid too.
You people only want kids because they are brainwashed by the patriarchy. Infertility wouldn't be an issue if women were emancipated and not brainwashed by the patriarchy.
Look, I've been feminist in online spaces since before some of you were born. I'm not unaware of the patriarchy and how it colours our choices.
But we have to stop infantilising women abd removing their agency. I know single women and lesbians who have spent decades working through their issues with the patriarchy...who still want kids and are dealing with fertility treatment. Sure, we will never be entirely free from the many ways society affects us. But that doesn't mean we're all blindly falling into motherhood.
You don't want kids, that's great. But it doesn't mean that every single woman choosing to have them is brainwashed and unable to understand what she is getting into - and it's pretty misogynistic to frame it that way.
Nobody should be having kids because the economy/environment/etc
OK there's a conversation to be had about cutting our carbon footprint and being aware of how our choices affect others and the planet. We should all be trying to live more sustainably - I say as I wear thrifted clothes whilst typing this on the train.
But... are you saying that to able bodied people having kids? Are you sacrificing everything that you want for the cause? Or is the easiest thing to give up the thing that someone else wants? I'm all for encouraging everyone to be mindful of the planet but we shouldn't be restricting the rights of people with a disability to make that happen.
We make choices for ourselves, not for other people.
Why not adopt or foster? Adopt don't shop!
Well this is a whole post in itself...but basically, please assume that anyone who is trying for kids for a while... has at least considered adoption. Please tryst people to choose the right option for them and their family.
Children are not puppies, and the massive adoption industry isn't always ethical or safe, can be hugely expensive (often moreso than IVF in some places!), and also doesn't actually guarantee that they get to have a child at the end of it.
There can be a lot of trauma and complicated feelings for the adopted child and their birth family and many kids need very specialised support that not every potential adoptive parent can provide.
There are also far more infertile couples than kids who need adoption - so not every individualor couple could adopt. Many kids just need temporary fostering with the aim of placing them back with their family, which is important but very different.
I intend to flesh out this argument more in a separate post but IMO adoption should ideally be rare - because birth parents should have free access to contraception, abortion and be empowered and supported to look after and raise their kids within their communities if they want them. Adoption should serve the needs of the child, not the potential parents. And certainly not the agencies.
If you truly believe there are millions of kids out there needing a home, why aren't you adopting? Why aren't you clamouring for every fertile couples to adopt? Because on some level society still that's these kids as a consolation prize. And because many of the people judging infertile couples for having IVF over adoption aren't all that invested in actially learning about these kids or helping them.
Infertile people aren't solely responsible for solving complex societal problems on their own. This is something that we as a whole society need to address.
The tumblr experience is your dash being filled with essay posts like "Steve and John are in love #myotp" and "actually the politico-magical implications of Jane's choices are really interesting for 75676 different reasons...
And trying to work it who the hell they are talking about and which IP they are referring to. I don't even know if I'm being spoiled, because I literally cannot find out which series they are referring to, because a lot of people, writing for their own audience, start from a position assuming everyone who will ever see their post knows who Squatty Jo is, and the context they are alluding to.
It does mean that when I'm perusing tumblr after a nap after a sleepless night on baby duty I feel like I might have slept for 100 yeats because I have no idea what my Dash are on about.
My memory was already bad at times but I can say that having a newborn...has not helped.
Basically if I don't write something down, then I'm playing roulette with when and if I will remember the thing.
And I'm eternally grateful for my baby tracking app because otherwise I'd probably gaslight myself constantly about when I fed or changed them. It's like time has no meaning any more. It feels like something just happened but it was 2 hours ago.
I dont know how primary caregivers in places like the US go back to work at this point. How do they cope? It's barbaric to make people go back to work so soon after having a child, when you're still very much recovering and barely coping.
I'm just glad most people in my life have appropriately low expectations when it comes to me replying. Unfortunately the cognitive effects of sleep deprivation make me feel like I'm constantly not doing enough, doing things wrong or constantly forgetting things for too long, which can feel a little but like you're always failing something, but I know this particular stage of mum guilt doesn't last forever.
I was watching a high school anime the other day and had the fleeting thought "this is such high school shit, I just cannot with this." And it occurred to me that I don't really enjoy high school series as much recently.
I want more stories about grownups leading interesting lives. Or disaster lives. But y'know, problems that can't just be resolved with a 1 minute conversation with your crush.
To be fair a good coming of age series is still really special.
On a mildly related note it reminds me of 1 Corinthians 13:11 I still have a conflicted relationship with that passage because people tend to have this idea it's about giving up simple measures and not maturing mentally and behaving like an adult in terns of deceliling a mature grasp ofethics rather than not liking cartoons.
