30 Weeks 1 Day

By Diana Nicholls

"Thirty weeks and one day. I lived every single day of that pregnancy in the moment, day by day, hour by hour. They were the weeks that put me through one of the biggest tests in my life."

For as long as she could remember, Diana would choo

• Language: English
• Publisher: DNPT Running
• Release date: Nov 24, 2020
• ISBN: 9781636846217

Book preview

Part one

DIARY ENTRY

7 weeks 4 days

I’m sitting in my gynaecologist-obstetrician’s waiting room, again. I’ve spent so much time here before, but today it’s for a different reason. This time it’s for the one reason I’ve been hoping for all along.

I’ve finally made it to this point.

She calls me in and congratulates me but all I can think is, Really? Congratulations? We have such a long road ahead. Anything can happen! Am I being negative? Given all the trouble I had last year, I find it hard to feel excited. My anxiety starts to kick in.

I leave her office with a booklet of information and a return appointment. On my way home, I laugh about having said to her, So, it’s not twins right? She replied, No. We’d have seen two heartbeats.

CHAPTER 1

Where it all began

Maybe no-one will notice me if I put my headphones on? I’ll escape to my own world, left to be – no fake smiles, no pretend bursts of energy, no questions to ask or answer, no conversation feigning interest for the sake of being polite. Most of the time, I am interested, but maybe this way no-one will notice the pain I’m in, my sluggishness, my unusually slow walk, my scattered thoughts, or flat demeanour. Perhaps I won’t be mistaken for a snob, or just plain rude.

On days that endometriosis² strikes, all I want to do is hide.

I often worry that people can notice my tired face and puffy eyes, my bloated stomach with its sharp, stabbing pains, and my sudden rushing to the bathroom. When I do speak, I wonder, can they hear what I hear; slurred words in slow motion?

All I want is to fall asleep; while ordering a coffee, during client appointments, at the supermarket, during a run, eating lunch – even while writing this!

Endometriosis is a debilitating condition, and it’s where this journey began over fifteen years ago.

I grew up with severe period pain, heavy bleeding, and blood clots. My symptoms worsened as the years went on, reaching the point where symptoms went from being present for only two or three days of my period to almost three weeks of each month. This lasted years. The most severe pain was during my period and ovulation. The rest of the time, the pain was due to a build-up of scar tissue and inflammation. I didn’t know how I’d feel from one day to the next. Sleeping for hours each afternoon became a daily ritual and bracing myself for the lower abdominal pain caused by sneezing, getting up off the couch, or in and out of my car became second nature.

I met with a gynaecologist-obstetrician in 2015 for what I thought would be a general check-up and brief discussion on fertility. After an internal examination – before I had the chance to sit back down – she told me she suspected I had endometriosis.

I’d heard about endometriosis, but even after seeing two doctors in my twenties about my period pain, I remained undiagnosed. On both occasions, I was told, That’s just how your body is. So, to be finally diagnosed in my mid-thirties was a shock. I felt I was to blame for not pursuing my health concerns early enough. Soon enough, I realised it’s impossible to find something you don’t know you’re looking for. Thankfully, times are changing, and today we’re more aware of the warning signs and symptoms of endometriosis than before.

I knew so little about endometriosis that for days after my diagnosis, I struggled to pronounce it, let alone spell it! I was oblivious to the fact that I had had this condition throughout my teen and adult years, even though the symptoms were screaming at me. I thought, I’m a woman, I get a period and it’s painful. So be it. When it comes to endometriosis, each woman’s symptoms can be so different. If you’re lucky, the pain will go unnoticed. If you’re not, it’s debilitating. Either way, endometriosis can be one of the causes of infertility.

Within minutes of my diagnosis, my gynaecologist showed me images of what the condition looked like. She explained that endometriosis could be why I was having trouble falling pregnant. I could only hear half of what she was saying; my heart was racing. We were both silent for a few seconds before she slid the box of tissues towards me. At that moment, I felt a sense of guilt. Had I done something wrong? Had I not looked after my body the way I should have? I was yet to understand that the condition was out of my control.

I sucked back my tears and asked a random question to shift the focus from my despair.

When she began to talk about laparoscopic surgery, she had my full attention. I’d never needed or had surgery before. My endometriosis required treatment before I could consider pregnancy. Naturally, I was concerned that having a baby would be a challenge, but I never imagined things happening the way they did, or that surgery would be so familiar to me now. I laugh now as I recall thinking, But I’m not someone who has surgery! The difference after the surgeries was so remarkable that I wondered how I’d managed to function properly before.

Previously, my need for sugar in the days leading up to my period was ridiculous for someone so health-conscious. It wouldn’t matter what else I ate; sugar was the only thing that gave me the energy I needed. My body was screaming out for the next hit and strangely enough, this was the only time I never felt sick from consuming so much of it.

Not only did endometriosis affect my day-to-day life, it also had a huge effect on my running. Some days I could run a marathon; others, I could barely reach 5 km. I spent a lot of time during a run managing my pain and energy levels, rather than enjoying the moment. I also had a lot of anxiety about running with others, often skipping social runs not just because of the pain, but because I feared I couldn’t keep up. I just never knew how my energy would be on any given day. As a running coach and personal trainer, I put pressure on myself to keep up with other runners around me.

There were many post-training sessions where I’d huddle into a ball on the grass until the acute pain subsided, while I tried to disguise my unique moves as a cool-down stretch! The inflammation was so bad that sometimes my stomach suddenly appeared four months pregnant. Other months I’d bleed so much that I was like a leaking tap. (Sorry, too much information!)

In 2013 I completed my third 100 km Oxfam Trailwalker. For almost two weeks before, I counted down to race day, but I wasn’t counting in excitement for the day. I was counting down in the hope that I could will my period to arrive earlier than its expected date, so it was over and done with before race day. (Of course, I was always going to run. I was so stubborn before my pregnancy. If I wasn’t dead, I was running!) I spent months preparing for the race, but it would all come down to timing on the day, and I knew endometriosis set its own agenda.

My period came the day after I finished the race, but that didn’t really matter; the overuse of pain killers had become my new normal over the years. That weekend, I chewed through anti-inflammatory tablets every few hours to stay on top of the painful cramps that usually arrived days before my period. I completed the 100 km event and smashed out another personal best. It’s an achievement I’m proud of to this day.

Was it worth it? Absolutely. Was it the smartest approach? Maybe not, but I’m not dead, and I’m still learning to manage this condition in the best way I can.

I spent the first half of 2016 focused on clearing endometrium. Then, at the start of April of 2017, I found out I was pregnant! It was a fluke of nature, given what my body had already endured.

For years I trained to run through the pain, and I would never let it stop me, but it took me a long time to recognise that the pain didn’t need me to stop, it just needed me to slow down a little. Maybe, this lesson was preparing me for pregnancy? Maybe, this lesson was trying to help me discover that in some marathons, personal bests don’t matter as much as the finish line does.

DIARY ENTRY

9 weeks 3 days

I notice a small bleed while on a break at work today, so I call my obstetrician and she advises me to come in for a scan. Driving there feels like it takes forever; I am so anxious.

I’m called in for my appointment and I give her a brief rundown before she says, Right, up on the bed. Let’s have a look.

There’s a lump in my throat. I’m nervous that I’ve miscarried.

I avoid looking at the screen and watch my obstetrician’s face instead. I thought her expression might give me a clue, but she looks slightly confused and has a grin on her face.

Have a look at this, she says with a smile. They’re twins, and I’m pretty sure they are identical.

Later that day

I’m at an appointment for my comprehensive ultrasound. My obstetrician put in a call to explain that we’ve just discovered I am in a twin pregnancy and that she suspects that only one placenta has formed.

Sure enough, it’s confirmed: identical twins with a shared placenta. Each has their own amniotic sac, which is positive; their cords won’t become entangled. But the shared placenta could affect delivery of nourishment to the fetuses. While they also told me that I’m now in a higher risk pregnancy, at this stage everything is forming well.

I walk back to my car, excited yet shocked. I’m carrying identical twins! I just hope they are going to be okay.

CHAPTER 2

Stopping nature in its tracks

I was oblivious to the complications, procedures, and stress that lay ahead when I left the clinic that day.

That day, I had no idea of how fortunate I was to have the choice to continue with my pregnancy, or how privileged I was to have the treatment I needed at my fingertips. Soon enough, I’d begin to realise how lucky I was to live in Melbourne, just twenty minutes from the Mercy Hospital for Women in Heidelberg, where I’d soon spend most of my time with the Perinatal Team. And soon, as I met other women who needed the same or similar treatment as me, I’d come to understand that sadly, some families weren’t in a position to go through complicated pregnancies. For them, this meant arranging travel, accommodation, food, care for their other children, or the unbearable task of relocating altogether.

That day, all I could think about was that I hoped nothing would happen to either one of the twins. Their lives began together – what would life be like for one if it was without the other?

Nature had decided to run its course, and due to the timing of when my egg split, my body formed one placenta instead of two. This wasn’t because my pregnancy was naturally conceived or wasn’t; whether I had looked after myself, or hadn’t; whether I was working too hard, or not. Nature had just decided it wasn’t going to play fair – and I was prepared to do everything I could to stop nature in its tracks.

Because of the unequal share of blood flow, a shared placenta can have a damaging impact on the growth of identical twins. In my case, Twin Two was giving her blood to Twin One. This resulted in Twin Two receiving too little and, therefore, not growing. Meanwhile, Twin One was receiving too much, putting her heart under stress. I was immediately put into the care of the team of specialist obstetricians and surgeons at the Mercy Hospital for Women.

My babies had a mere 10% chance of survival.

My husband Cam and I quickly learnt that termination was one option available to us. We could either undergo a complete termination or reduce the twin pregnancy to a singleton, giving Twin One the best chance. I knew immediately that neither of these scenarios were an option.

Thankfully, when it came to making decisions on how to move forward, Cam and I shared the same views. Had our views differed, things would have been much more difficult. We had more serious procedures to consider,