As a documentary photographer I carry my camera(s) with me everywhere I go. Having one with me all the time is now part of me and if I don’t have it for some reason then it just doesn’t feel right somehow and I feel anxious or out of kilter. I photograph much of what I see. Good and bad. Hopefully I do it with respect to those I photograph and show with honesty the life and events that surround us all. It’s what I do as my profession and in my spare time and it defines who I am.
Alongside this and something that is unknown to anyone, even those that are closest to me, is that I have also carried with me a small knitted woollen bonnet that I stored in either my camera bag or my pouches when I carried my camera gear.
The bonnet belonged to my daughter Rose. Three years ago she was born far too early at 24 weeks as a result of a placental abruption in my partner Sara and after an all too brief battle with life she died an hour or so after her arrival. I wrote about it HERE and the bonnet she was dressed in when we saw her for the last time at the hospital is the one I carry with my cameras.
Twenty one weeks ago we decided to try again. As was the case with Rose the only option was to go down the route of IVF. Sara has a medical condition that means this was the only viable option for her to try to become pregnant and so, as those who have gone through IVF treatment will know all too well, we once again started down an emotional roller coaster of a road that was always going to be long, difficult and full of hurdles.
After the initial procedure to extract and fertilise the eggs two successfully fertilised embryos were then re-introduced to give a greater chance of one of them working.
After the IVF procedure had been done and before a pregnancy test was carried out a couple of weeks later there followed a continuous requirement for injections and tablets to try and give the introduced embryos a greater chance of succeeding and then if it did work the use of these drugs was to continue to allow the pregnancy to develop as it should.
When the test was done it came back positive showing Sara to be pregnant. Following a confirmatory scan at the hospital we were then told the surprising news that she was in fact pregnant with twins. This is something that there is an increased chance of with IVF but it still comes as a bit of a surprise!
A relentless course of hormone injections then followed every other day and with the previous history of placental abruption further tablets and pessaries were also needed along with a blood thinner called Enoxaparin that was injected daily which reduced the risk of it happening again. The results of all these injections was an ever increasing array of bruising stretching over her stomach and thighs.
About four weeks in to the pregnancy problems started to arise and Sara was taken into hospital in severe pain. One of the effects of IVF treatment can be over stimulation of the ovaries and which can cause cysts to form. This is what happened here and in turn this then caused the kidney function to be disrupted as the pressure on them increased and the natural function of the kidneys was affected. As a result she started to go into kidney failure.
The only way to resolve this problem and to try and avoid having to use a kidney dialysis machine was to carry out a nephrostomy. This operation involves inserting a tube through the side of the body to drain urine directly from the kidney and out into a bag which is attached to the outside of the body. Sara had a double-nephrostomy so there was a bag attached to either side for each Kidney to drain into.
This set of circumstances is very unusual. Doctors at James Cook Hospital informed us that this was only the tenth known case in the country that this set of circumstances had occurred – blocked kidney function due to IVF treatment – and that it was the first time that they had ever seen it at this hospital. Needless to say it was a long and difficult process to try and find a workable resolution to this whilst at the same time trying maintain what was already going to be a difficult pregnancy.
Through the weeks that followed there were many trips to the hospital due to infections caused by the attached wires of the nephrostomy procedure. There were numerous trips to the ‘out of hours‘ GP clinic to seek advice and treatment. There were understandable delays in treatment at these clinics because of the complicated circumstances surrounding the pregnancy. There were long and frustrating nights spent sitting in A and E listening to drunken or drugged up arseholes moaning on about how bad they were feeling as we waited to be treated. There were endless blood tests. Catheters fitted and removed. Leaking bags and an endless stream of prescriptions that needed to be filled. Constant pain.
By way of an example below is a breakdown of some of the numbers and statistics from over the last 21 weeks…
A and E visits – 5
Hospital stays – 4 (The longest one being 3 weeks)
Calls to the 101 out of hours service – 4 (Three times in one day)
Visits to the out of hours GP – 3
Ambulance trips – 2
Medical staff working on the case – 7 consultants, 1 doctor and 1 midwife
Ultrasounds carried out – Unknown (Too many to remember)
Blood tests carried out – 50
Cannula’s inserted during the first three weeks – 26 (Around 40 in total)
Drugs used – Morphine, paracetamol, Enoxaparin, Tramadol, anti-biotics, codeine, IV drips
Associated infections – Strep B, Gastroenteritis, Gastritis, bladder retention, Renal failure, unknown allergic reaction to one of the drugs, ongoing UTI’s (urinary tract infections)
There were many frustrations. There were times when we went for many hours without any sleep. I think the longest I went was around 60 hours or so. There were many many times when sleep was disrupted in order to change one or both of the nephrostomy bags as they leaked or didn’t drain properly through the night. She suffered incredible pain at times due to the infections that came because of the bags. Forced to sleep in only one position each night because of the placement of the bags she suffered back problems and aches and pains that was not the level of disruption and stress any pregnant woman needs.
Throughout all of this and almost in the background, almost secondary to all the nephrostomy related issues was the pregnancy itself. The scans showed good progress as the twins – now both identified as girls – continued to grow as they should be and with this a slow and restrained confidence began to develop as we thought that things might work out this time round. But we also knew that all this strain and effort by the body to deal with all these issues was a difficult task and one that was taking its toll.
On the morning of Wednesday 29 July Sara noticed some bleeding so we went to the hospital to get checked out at the maternity assessment unit. A check-up revealed that all seemed to be in order and that there might be some indications of another small infection but generally all seemed ok. So relieved that it wasn’t more serious we headed off for the day. At home later that evening Sara’s water broke and she was immediately taken by ambulance into hospital where we then spent a long and sleepless night waiting to see how things would turn out but knowing things didn’t look good.
The waters had broken for one of the babies but the other one remained intact. However we knew that with twins if one started to deliver then it is very unusual for the other to remain in the womb and not be delivered as well so as the pains and cramps started to become more regular through the early morning it became an inevitable and sad reality that this wasn’t going to go well.
On the morning of Thursday 30 July at 05.50 hrs and 06.21 hrs respectively and arriving prematurely at 21 weeks Martha and Isabelle made an all too brief appearance and at the same time caused a lasting impact on the world. On our world at least.
The journey through the IVF treatment and the associated difficulties had once again reached a sad and devastating conclusion. Despite the best efforts of so many medical staff along the way and despite the bravery and determination of Sara and her ability to endure discomfort and pain levels so high and for such a long period of time that I was constantly in awe of how she did it there were just too many obstacles in the way. But she never stopped battling despite all that faced her.
So once again we found ourselves sitting in a small and quiet room in a side ward at James Cook Hospital. Listening as we waited to the hum of an air conditioner and the muffled sounds of hospital life going on around us. Waiting for something that you hoped you would never have to go through again.
For a small basket to be brought into the room and laid in front of us.
This time we looked down at two tiny and beautiful but heart wrenching faces huddled together and wrapped in a swath of soft blankets.
The noise of the air conditioner had gone. As had the sounds of the hospital.
I now carry three woollen bonnets in my camera bag.
In memory of Martha & Isabelle
Born 30 July 2015
I would like to express our thanks to Mr Mohammed from the IVF clinic who throughout this journey has consistently gone way above and beyond what he needed to do and to all his staff at the department. To the midwives, nurses and doctors who have all helped along the way and shown total professionalism. To the ambulance crews and paramedics who came and assisted so speedily with getting Sara into hospital. To the on-call doctor who gave us a steer on how to by-pass NHS procedure in order to get through A and E quicker. To friends and family who have offered their support along the way. We appreciate all your efforts. You’re good people.
And most of all to Sara. You never stopped fighting.
All images were shot on a Leica M9 fitted with a 50mm f2 Summicron lens.
Photographs were edited into black and white using Lightroom 5.
See more of my work on my website and blogs via the link….. HERE
Images copyright Ian Forsyth 2015. All rights reserved.
No usage without arrangement.