Saturday, June 29, 2013

'My wife was told I was a goner': In this deeply emotional and brave interview, Andrew Marr tells for the first time how he almost died - twice

Six months ago, Andrew Marr was exercising in the mini-gym he’d rigged up in his garden shed.
Having been forced to give up running because he’d worn out his knees, he’d bought a rowing machine.
Since he’s a keep-fit addict, he’d read a new theory that short bursts of intensive exercise were just as good as the long runs that used to be his favourite way of winding down when he wasn’t broadcasting for the BBC.

So there he was, pulling away at the rowing machine with characteristic vigour.
‘I was a classic male, trying to ignore the fact that I was getting older,’ Marr recalls.
‘I was trying to do all the physical things I could do when I was 20 years younger — refusing to accept I was now 53 years old.’
He says his aim was to row the equivalent of five kilometres in 20 minutes — a target he had frustratingly failed to reach before that day.
On this occasion, with a great sense of achievement, he did it.
‘But the elation was soon replaced with a very strange feeling. I was gasping and feeling sick. But I put it down to achieving my tough goal.
‘Then I had a strange feeling in the back of my neck and an abiding sense that I had just done something stupid because something was wrong.’
In fact, although he didn’t realise it at the time, he had torn his carotid artery, which caused a massive stroke.
Now, slowly recovering, Andrew is giving his first interview about that dramatic moment when he almost died — and which has turned his hectic life upside down.
‘The first sensation was really intense — a sharp headache just above and behind my right eye. There was a kind of waterfall of brightly coloured light — lots of colours, moving fast, from right to left. They were rather beautiful, actually.
‘I thought it was a migraine, although I’d never had one before. It never occurred to me it was a stroke.’
Thus he went back into the house and proceeded to carry on as normal — cooking a meal for his family. But his headache was still intense.
‘We all sat down after dinner to watch a film — it was George Clooney in The American. Not a very good film.’
With typical Marr humour, he jokes: ‘I’m very glad, as things worked out, that was not the last artistic work I saw on this planet!’
As the pain in his head continued, his wife, Jackie, became worried but Marr refused to let her call a doctor. He thought it was just over-exertion and the pain would soon subside.


But a couple of hours later, when it didn’t go away, his wife again said she wanted to call a doctor.
‘I didn’t let her. I was still convinced it was a bad headache. The colours in my eyes had gone, although I was still exhausted, which I put down to the hard bout on the rowing machine. I felt ill, but not very ill, so I took two paracetamol and went to bed.’
Of course he now realises that he should have called a doctor at once and that if he had done, the consequences of the massive bleed in his brain would have been less severe.
‘It would have made a big difference, but I wouldn’t listen,’ he says. ‘I did have an uneasy feeling, like a good evening that had gone wrong, but I can’t describe it as more than that.’
However, it was clear the next morning that he had suffered a very serious injury, for he woke early and found that he had fallen out of bed during the night.
‘All I remember is lying there, deeply irritated. I tried to get up but couldn’t. On reflection I realise it was because my left arm and leg were very weak and weren’t working. 
'Eventually I managed to get up using my other arm and leg, but it took a very long time to get off the floor. It was only when I was trying to lift my foot to get into the shower, but couldn’t raise it, that I thought something was up.
‘Then I looked in the mirror and saw the reflection of a slightly hostile, strange man with a downwards droop of his mouth. That was the moment when I realised I’d had a stroke.’


He says that, like most people, he’d read about people suffering strokes but never thought that someone who was fit and in his early 50s, like himself, would ever have one.
Immediately, his wife phoned his sister, Lucy, who is a doctor; Lucy told her to call for an ambulance straight away.
With his left arm and leg still ‘feeling as heavy as lead’, Marr says his initial reaction was ‘deep irritation with myself’.
When the ambulance arrived, the paramedics confirmed it was a stroke and Marr recalls one of them asking their colleague: “Should we blue this one?” — in other words whether it was an emergency and should they turn on the ambulance’s blue flashing lights and siren during the journey to hospital.
Marr now quips: ‘That made me feel childishly proud when they turned it on — as if I had passed a test.’
It was 7.30am and although there were a number of hospitals he could have been taken to, the paramedics drove to Charing Cross, which has the country’s highest survival rates  for strokes.
Marr’s wife and their two daughters, Emily and Isabel, followed separately. (The couple also have an older son Harry, who was at work.) By this stage, he says, although he didn’t feel afraid, he was confused and not thinking clearly.
It is only now that he is able to reflect properly on what happened and the possible causes. In retrospect, he says, he remembers an incident a couple of months earlier.
‘I was in Macedonia filming the History Of The World series and trying to do a piece to camera. I write all my own material and then roughly memorise the script. It was something that I had done thousands of times.
‘We were at the remote mountain site where Alexander The Great was taught by Aristotle and I was standing in the mouth of a cave.
‘But for the first time in my life I just couldn’t get the words out. I had never failed to do a piece to camera before, and I was bewildered. I was also exhausted beyond belief.’
The crew decided to delay filming and took Marr to the nearest village, where he spent most of the rest of the day asleep in the back of a car. The next day he felt fine and resumed filming. But, in fact, he had suffered a minor stroke — evidence of which was found in the form of scarring when his brain was scanned at London’s Charing Cross Hospital in January.
Indeed, that stroke in Macedonia was not Marr’s first. He says: ‘There was evidence of minor strokes I’d had before — but I have no memory of them.’
So what could have triggered them? Over-work? Heredity? Age?
Official statistics show that strokes are the third biggest cause of death — and somebody suffers one in Britain every five minutes.


A stroke is brain damage caused by a blocked blood vessel or bleeding in the brain and can occur at any age but is most common in over-65s (the risk approximately doubles for each decade of life after age 55).
In all, there are around 1.2 million stroke survivors in the UK — more than half being left with disabilities that affect their daily life.
Marr has his own thoughts as to why he had one — or in fact several.
‘No one seems to know for certain what causes a stroke, but having had time to think, I can now see  that I had been grossly overdoing things.
‘The filming of the History Of The World series was gruelling — very stressful and involving huge amounts of travel. Also, I was aware that the series hadn’t gone as well as I’d hoped. I was also doing the Andrew Marr Show on television every Sunday, and Start The Week on Radio Four every Monday. I was writing a book, too.
‘It had also been easily the most stressful time of my personal life — and entirely my own fault.’
He is referring to the turmoil in his marriage caused by his extra-marital affair with another journalist, which he initially tried  to keep secret by the use of a super-injunction.
At the time, he believed he had fathered a child with the other woman, but a DNA test eventually showed he was not the girl’s father. He then said he was ‘embarrassed’ by the injunction, and stopped seeking to prevent the story being published.


Marr says overwork must have been a key contributory factor to his stroke.
‘I was working too hard. No one made me do it, that’s just the way I am.
‘I’m a gulper, a gobbler-down of life. I wolf experiences down and, that year, I pushed my body and my mind too hard and far.’
If those were the background conditions, then the specific trigger is easier to pinpoint.
‘As well as my workload and family life, I was up at 6.30 most mornings running around Richmond Park. I’d done that for 30 years, it helped relieve the stress and I loved it.
‘But some years ago I snapped my Achilles tendon. That was a warning my legs were giving up on me.
‘The doctor said I had the heart of a 35-year-old but the knees of a 70-year-old and I had to give up running. It was then that I bought the rowing machine.’
Glasgow-born Marr, who has been a newspaper editor as well as the BBC’s political editor, is now undergoing physiotherapy, and is eager to return to television.
For the past month, he has been staying during the week in a small hotel near the Neurological Hospital at Queen Square in Bloomsbury, London, for intensive rehab for his left arm.
At weekends he’s back at his home in East Sheen, where we are sitting in the rambling garden — within view of the shed where he suffered that massive stroke.
The rowing machine has since been removed and the shed, where he wrote his TV series, is more of a study. It’s filled with his paintings and books, but he doesn’t venture down there much now.
He walks with an awkward gait because the stroke damaged both his left arm and leg, the latter recovering more quickly.
He is able to pour us each a glass of wine, and grabs a packet of mini poppadoms to snack on before returning to his favourite chair.
Thankfully, the stroke hit the left side of his brain — which means his memory and speech are not impaired. The most noticeable difference is that his left arm is not working properly yet, and he wears a brace on his left ankle to stop his foot from flopping when he walks.
Marr likens himself to a building that is undergoing major refurbishment, with parts of its structure in a very delicate condition.
‘My left arm functions mainly as a kind of wild, malign hook, seizing and knocking over cups, cutlery, plates and so on, with no reference to its owner’s dignity or comfort.
‘Making it to the bathroom first thing in the morning is at least as difficult as skiing down an icy black run, with poor visibility.’
However, despite such problems, that characteristic Andrew Marr smile plays about his lips as he recalls the aftermath of his collapse.
The first few days in intensive care, he says, were a blur. Only later was he told by doctors that he almost died twice, and that his wife had been told to expect the worst.
‘I vaguely remember arriving in the hyper-acute stroke unit, then going to theatre for a brain scan.’
The medical staff injected dye into his bloodstream so that when he was X-rayed they could tell how well the blood was flowing into  certain areas.
Marr says: ‘It wasn’t enormously pleasant. It felt like having a cup of hot tea poured into my brain.’
He also remembers several consultants standing around him, debating whether to operate immediately to remove a clot in his artery, or to give him clot-busting drugs which one of them told him could have ‘catastrophic side-effects’.
‘They inserted a tube into the artery via my groin, up through my aorta and into the carotid artery in my neck. But then they decided it was too dangerous to operate.’


Instead, they decided to treat him with drugs.
‘There is no doubt they saved my life, but there was a second bleed into my brain. My condition seemed to be very much touch-and-go.
‘I wouldn’t know this until later, but Jackie was twice given the clear impression that I was a goner. If I was very lucky, I would be a  vegetable, unable to move, see, hear or speak.’
Such crises can bring couples together — or break them apart. For Andrew and Jackie, it has been the former.
From the moment he collapsed, Jackie hardly left his side. She has been next to him every morning when he wakes, and every night when he falls asleep.
Of one thing he is adamant.
‘Jackie saved my life. Without her, I wouldn’t be here.
‘It’s partly because she fought for me; she was my tireless advocate in the hospital to get the right treatment.
‘Jackie was very strongly affected by what happened to me. In many ways, it was much more of a shock for her than it was for me since I hadn’t realised how close I was to dying.
‘She was very brave and very sensitive in not telling me everything until I was stronger. And then she really carried me. She was on the case the whole time, overseeing food and keeping my morale up.
‘She never wavered in assuming that I would make a full recovery and get back to work. She immediately dropped everything — including her column at The Guardian — while she was looking after me.
‘She has been completely calming and reassuring, as well as a great practical carer, and the whole  experience has brought us more closely together.’
Their children rallied round, too, returning from university and school to help — even, Marr says, when they had ‘much more exciting things to do’. He adds: ‘I don’t think I could have got through half as well as I have without them.’
Friends who have visited him since his stroke all say they have witnessed no self-pity.
Despite his physical problems, his intelligence has not been dimmed one iota, nor has he lost the ability to discuss with friends the great issues of the day over a glass of wine and good food.
I have known Andrew Marr for many years, and he is not a man given to showing his emotions, let alone to talking about them.
He says: ‘Some people told me after what happened that I had to express my emotions — that I had to cry and to let it out. Perhaps it’s my Presbyterian upbringing, but there were no tears from me — even though there were many from others.
‘I remember thinking that if I’d allowed myself to cry, who knows where it would stop. There are few things less attractive than self-pity.
‘I was never angry and I never asked: “Why did it happen to me?”
‘In hospital, I was surrounded by people in far worse situations than I was. They were all very brave, very tough and very cheerful. Being around people like that is a great antidote to self-pity.
‘In any case, I have had a very lucky life. It would have been a bit pathetic to collapse at the first bit of bad luck.’.

Thursday, June 20, 2013

How Long Can You Wait to Have a Baby?

In the tentative, post-9/11 spring of 2002, I was, at 30, in the midst of extricating myself from my first marriage. My husband and I had met in graduate school but couldn’t find two academic jobs in the same place, so we spent the three years of our marriage living in different states. After I accepted a tenure-track position in California and he turned down a postdoctoral research position nearby—the job wasn’t good enough, he said—it seemed clear that our living situation was not going to change.
I put off telling my parents about the split for weeks, hesitant to disappoint them. When I finally broke the news, they were, to my relief, supportive and understanding. Then my mother said, “Have you read Time magazine this week? I know you want to have kids.”
Time’s cover that week had a baby on it. “Listen to a successful woman discuss her failure to bear a child, and the grief comes in layers of bitterness and regret,” the story inside began. A generation of women who had waited to start a family was beginning to grapple with that decision, and one media outlet after another was wringing its hands about the steep decline in women’s fertility with age: “When It’s Too Late to Have a Baby,” lamented the U.K.’s Observer; “Baby Panic,” New York magazine announced on its cover.
The panic stemmed from the April 2002 publication of Sylvia Ann Hewlett’s headline-grabbing book, Creating a Life, which counseled that women should have their children while they’re young or risk having none at all. Within corporate America, 42 percent of the professional women interviewed by Hewlett had no children at age 40, and most said they deeply regretted it. Just as you plan for a corner office, Hewlett advised her readers, you should plan for grandchildren.
The previous fall, an ad campaign sponsored by the American Society for Reproductive Medicine (ASRM) had warned, “Advancing age decreases your ability to have children.” One ad was illustrated with a baby bottle shaped like an hourglass that was—just to make the point glaringly obvious—running out of milk. Female fertility, the group announced, begins to decline at 27. “Should you have your baby now?” asked Newsweek in response.
For me, that was no longer a viable option.
I had always wanted children. Even when I was busy with my postdoctoral research, I volunteered to babysit a friend’s preschooler. I frequently passed the time in airports by chatting up frazzled mothers and babbling toddlers—a 2-year-old, quite to my surprise, once crawled into my lap. At a wedding I attended in my late 20s, I played with the groom’s preschool-age nephews, often on the floor, during the entire rehearsal and most of the reception. (“Do you fart?” one of them asked me in an overly loud voice during the rehearsal. “Everyone does,” I replied solemnly, as his grandfather laughed quietly in the next pew.)
But, suddenly single at 30, I seemed destined to remain childless until at least my mid-30s, and perhaps always. Flying to a friend’s wedding in May 2002, I finally forced myself to read the Time article. It upset me so much that I began doubting my divorce for the first time. “And God, what if I want to have two?,” I wrote in my journal as the cold plane sped over the Rockies. “First at 35, and if you wait until the kid is 2 to try, more than likely you have the second at 38 or 39. If at all.” To reassure myself about the divorce, I wrote, “Nothing I did would have changed the situation.” I underlined that.
I was lucky: within a few years, I married again, and this time the match was much better. But my new husband and I seemed to face frightening odds against having children. Most books and Web sites I read said that one in three women ages 35 to 39 would not get pregnant within a year of starting to try. The first page of the ASRM’s 2003 guide for patients noted that women in their late 30s had a 30 percent chance of remaining childless altogether. The guide also included statistics that I’d seen repeated in many other places: a woman’s chance of pregnancy was 20 percent each month at age 30, dwindling to 5 percent by age 40.
Every time I read these statistics, my stomach dropped like a stone, heavy and foreboding. Had I already missed my chance to be a mother?
As a psychology researcher who’d published articles in scientific journals, some covered in the popular press, I knew that many scientific findings differ significantly from what the public hears about them. Soon after my second wedding, I decided to go to the source: I scoured medical-research databases, and quickly learned that the statistics on women’s age and fertility—used by many to make decisions about relationships, careers, and when to have children—were one of the more spectacular examples of the mainstream media’s failure to correctly report on and interpret scientific research.
The widely cited statistic that one in three women ages 35 to 39 will not be pregnant after a year of trying, for instance, is based on an article published in 2004 in the journal Human Reproduction. Rarely mentioned is the source of the data: French birth records from 1670 to 1830. The chance of remaining childless—30 percent—was also calculated based on historical populations.
In other words, millions of women are being told when to get pregnant based on statistics from a time before electricity, antibiotics, or fertility treatment. Most people assume these numbers are based on large, well-conducted studies of modern women, but they are not. When I mention this to friends and associates, by far the most common reaction is: “No … No way. Really?
Surprisingly few well-designed studies of female age and natural fertility include women born in the 20th century—but those that do tend to paint a more optimistic picture. One study, published in Obstetrics & Gynecology in 2004 and headed by David Dunson (now of Duke University), examined the chances of pregnancy among 770 European women. It found that with sex at least twice a week, 82 percent of 35-to-39-year-old women conceive within a year, compared with 86 percent of 27-to-34-year-olds. (The fertility of women in their late 20s and early 30s was almost identical—news in and of itself.) Another study, released this March in Fertility and Sterility and led by Kenneth Rothman of Boston University, followed 2,820 Danish women as they tried to get pregnant. Among women having sex during their fertile times, 78 percent of 35-to-40-year-olds got pregnant within a year, compared with 84 percent of 20-to-34-year-olds. A study headed by Anne Steiner, an associate professor at the University of North Carolina School of Medicine, the results of which were presented in June, found that among 38- and 39-year-olds who had been pregnant before, 80 percent of white women of normal weight got pregnant naturally within six months (although that percentage was lower among other races and among the overweight). “In our data, we’re not seeing huge drops until age 40,” she told me.
Even some studies based on historical birth records are more optimistic than what the press normally reports: One found that, in the days before birth control, 89 percent of 38-year-old women were still fertile. Another concluded that the typical woman was able to get pregnant until somewhere between ages 40 and 45. Yet these more encouraging numbers are rarely mentioned—none of these figures appear in the American Society for Reproductive Medicine’s 2008 committee opinion on female age and fertility, which instead relies on the most-ominous historical data.
In short, the “baby panic”—which has by no means abated since it hit me personally—is based largely on questionable data. We’ve rearranged our lives, worried endlessly, and forgone countless career opportunities based on a few statistics about women who resided in thatched-roof huts and never saw a lightbulb. In Dunson’s study of modern women, the difference in pregnancy rates at age 28 versus 37 is only about 4 percentage points. Fertility does decrease with age, but the decline is not steep enough to keep the vast majority of women in their late 30s from having a child. And that, after all, is the whole point.
I am now the mother of three children, all born after I turned 35. My oldest started kindergarten on my 40th birthday; my youngest was born five months later. All were conceived naturally within a few months. The toddler in my lap at the airport is now mine.
Instead of worrying about my fertility, I now worry about paying for child care and getting three children to bed on time. These are good problems to have.
Yet the memory of my abject terror about age-related infertility still lingers. Every time I tried to get pregnant, I was consumed by anxiety that my age meant doom. I was not alone. Women on Internet message boards write of scaling back their careers or having fewer children than they’d like to, because they can’t bear the thought of trying to get pregnant after 35. Those who have already passed the dreaded birthday ask for tips on how to stay calm when trying to get pregnant, constantly worrying—just as I did—that they will never have a child. “I’m scared because I am 35 and everyone keeps reminding me that my ‘clock is ticking.’ My grandmother even reminded me of this at my wedding reception,” one newly married woman wrote to me after reading my 2012 advice book, The Impatient Woman’s Guide to Getting Pregnant, based in part on my own experience. It’s not just grandmothers sounding this note. “What science tells us about the aging parental body should alarm us more than it does,” wrote the journalist Judith Shulevitz in a New Republic cover story late last year that focused, laser-like, on the downsides of delayed parenthood.
How did the baby panic happen in the first place? And why hasn’t there been more public pushback from fertility experts?
One possibility is the “availability heuristic”: when making judgments, people rely on what’s right in front of them. Fertility doctors see the effects of age on the success rate of fertility treatment every day. That’s particularly true for in vitro fertilization, which relies on the extraction of a large number of eggs from the ovaries, because some eggs are lost at every stage of the difficult process. Younger women’s ovaries respond better to the drugs used to extract the eggs, and younger women’s eggs are more likely to be chromosomally normal. As a result, younger women’s IVF success rates are indeed much higher—about 42 percent of those younger than 35 will give birth to a live baby after one IVF cycle, versus 27 percent for those ages 35 to 40, and just 12 percent for those ages 41 to 42. Many studies have examined how IVF success declines with age, and these statistics are cited in many research articles and online forums.
Yet only about 1 percent of babies born each year in the U.S. are a result of IVF, and most of their mothers used the technique not because of their age, but to overcome blocked fallopian tubes, male infertility, or other issues: about 80 percent of IVF patients are 40 or younger. And the IVF statistics tell us very little about natural conception, which requires just one egg rather than a dozen or more, among other differences.
Studies of natural conception are surprisingly difficult to conduct—that’s one reason both IVF statistics and historical records play an outsize role in fertility reporting. Modern birth records are uninformative, because most women have their children in their 20s and then use birth control or sterilization surgery to prevent pregnancy during their 30s and 40s. Studies asking couples how long it took them to conceive or how long they have been trying to get pregnant are as unreliable as human memory. And finding and studying women who are trying to get pregnant is challenging, as there’s such a narrow window between when they start trying and when some will succeed.

Another problem looms even larger: women who are actively trying to get pregnant at age 35 or later might be less fertile than the average over-35 woman. Some highly fertile women will get pregnant accidentally when they are younger, and others will get pregnant quickly whenever they try, completing their families at a younger age. Those who are left are, disproportionately, the less fertile. Thus, “the observed lower fertility rates among older women presumably overestimate the effect of biological aging,” says Dr. Allen Wilcox, who leads the Reproductive Epidemiology Group at the National Institute of Environmental Health Sciences. “If we’re overestimating the biological decline of fertility with age, this will only be good news to women who have been most fastidious in their birth-control use, and may be more fertile at older ages, on average, than our data would lead them to expect.”
These modern-day research problems help explain why historical data from an age before birth control are so tempting. However, the downsides of a historical approach are numerous. Advanced medical care, antibiotics, and even a reliable food supply were unavailable hundreds of years ago. And the decline in fertility in the historical data may also stem from older couples’ having sex less often than younger ones. Less-frequent sex might have been especially likely if couples had been married for a long time, or had many children, or both. (Having more children of course makes it more difficult to fit in sex, and some couples surely realized—eureka!—that they could avoid having another mouth to feed by scaling back their nocturnal activities.) Some historical studies try to control for these problems in various ways—such as looking only at just-married couples—but many of the same issues remain.
The best way to assess fertility might be to measure “cycle viability,” or the chance of getting pregnant if a couple has sex on the most fertile day of the woman’s cycle. Studies based on cycle viability use a prospective rather than retrospective design—monitoring couples as they attempt to get pregnant instead of asking couples to recall how long it took them to get pregnant or how long they tried. Cycle-viability studies also eliminate the need to account for older couples’ less active sex lives. David Dunson’s analysis revealed that intercourse two days before ovulation resulted in pregnancy 29 percent of the time for 35-to-39-year-old women, compared with about 42 percent for 27-to-29-year-olds. So, by this measure, fertility falls by about a third from a woman’s late 20s to her late 30s. However, a 35-to-39-year-old’s fertility two days before ovulation was the same as a 19-to-26-year-old’s fertility three days before ovulation: according to Dunson’s data, older couples who time sex just one day better than younger ones will effectively eliminate the age difference.
Don’t these numbers contradict the statistics you sometimes see in the popular press that only 20 percent of 30-year-old women and 5 percent of 40-year-old women get pregnant per cycle? They do, but no journal article I could locate contained these numbers, and none of the experts I contacted could tell me what data set they were based on. The American Society for Reproductive Medicine’s guide provides no citation for these statistics; when I contacted the association’s press office asking where they came from, a representative said they were simplified for a popular audience, and did not provide a specific citation.
Dunson, a biostatistics professor, thought the lower numbers might be averages across many cycles rather than the chances of getting pregnant during the first cycle of trying. More women will get pregnant during the first cycle than in each subsequent one because the most fertile will conceive quickly, and those left will have lower fertility on average.
Most fertility problems are not the result of female age. Blocked tubes and endometriosis (a condition in which the cells lining the uterus also grow outside it) strike both younger and older women. Almost half of infertility problems trace back to the man, and these seem to be more common among older men, although research suggests that men’s fertility declines only gradually with age.
Fertility problems unrelated to female age may also explain why, in many studies, fertility at older ages is considerably higher among women who have been pregnant before. Among couples who haven’t had an accidental pregnancy—who, as Dr. Steiner put it, “have never had an ‘oops’ ”—sperm issues and blocked tubes may be more likely. Thus, the data from women who already have a child may give a more accurate picture of the fertility decline due to “ovarian aging.” In Kenneth Rothman’s study of the Danish women, among those who’d given birth at least once previously, the chance of getting pregnant at age 40 was similar to that at age 20.
Older women’s fears, of course, extend beyond the ability to get pregnant. The rates of miscarriages and birth defects rise with age, and worries over both have been well ventilated in the popular press. But how much do these risks actually rise? Many miscarriage statistics come from—you guessed it—women who undergo IVF or other fertility treatment, who may have a higher miscarriage risk regardless of age. Nonetheless, the National Vital Statistics Reports, which draw data from the general population, find that 15 percent of women ages 20 to 34, 27 percent of women 35 to 39, and 26 percent of women 40 to 44 report having had a miscarriage. These increases are hardly insignificant, and the true rate of miscarriages is higher, since many miscarriages occur extremely early in a pregnancy—before a missed period or pregnancy test. Yet it should be noted that even for older women, the likelihood of a pregnancy’s continuing is nearly three times that of having a known miscarriage.
What about birth defects? The risk of chromosomal abnormalities such as Down syndrome does rise with a woman’s age—such abnormalities are the source of many of those very early, undetected miscarriages. However, the probability of having a child with a chromosomal abnormality remains extremely low. Even at early fetal testing (known as chorionic villus sampling), 99 percent of fetuses are chromosomally normal among 35-year-old pregnant women, and 97 percent among 40-year-olds. At 45, when most women can no longer get pregnant, 87 percent of fetuses are still normal. (Many of those that are not will later be miscarried.) In the near future, fetal genetic testing will be done with a simple blood test, making it even easier than it is today for women to get early information about possible genetic issues.
What does all this mean for a woman trying to decide when to have children? More specifically, how long can she safely wait?
This question can’t be answered with absolutely certainty, for two big reasons. First, while the data on natural fertility among modern women are proliferating, they are still sparse. Collectively, the three modern studies by Dunson, Rothman, and Steiner included only about 400 women 35 or older, and they might not be representative of all such women trying to conceive.
Second, statistics, of course, can tell us only about probabilities and averages—they offer no guarantees to any particular person. “Even if we had good estimates for the average biological decline in fertility with age, that is still of relatively limited use to individuals, given the large range of fertility found in healthy women,” says Allen Wilcox of the NIH.
So what is a woman—and her partner—to do?
The data, imperfect as they are, suggest two conclusions. No. 1: fertility declines with age. No. 2, and much more relevant: the vast majority of women in their late 30s will be able to get pregnant on their own. The bottom line for women, in my view, is: plan to have your last child by the time you turn 40. Beyond that, you’re rolling the dice, though they may still come up in your favor. “Fertility is relatively stable until the late 30s, with the inflection point somewhere around 38 or 39,” Steiner told me. “Women in their early 30s can think about years, but in their late 30s, they need to be thinking about months.” That’s also why many experts advise that women older than 35 should see a fertility specialist if they haven’t conceived after six months—particularly if it’s been six months of sex during fertile times.
There is no single best time to have a child. Some women and couples will find that starting—and finishing—their families in their 20s is what’s best for them, all things considered. They just shouldn’t let alarmist rhetoric push them to become parents before they’re ready. Having children at a young age slightly lowers the risks of infertility and chromosomal abnormalities, and moderately lowers the risk of miscarriage. But it also carries costs for relationships and careers. Literally: an analysis by one economist found that, on average, every year a woman postpones having children leads to a 10 percent increase in career earnings.
For women who aren’t ready for children in their early 30s but are still worried about waiting, new technologies—albeit imperfect ones—offer a third option. Some women choose to freeze their eggs, having a fertility doctor extract eggs when they are still young (say, early 30s) and cryogenically preserve them. Then, if they haven’t had children by their self-imposed deadline, they can thaw the eggs, fertilize them, and implant the embryos using IVF. Because the eggs will be younger, success rates are theoretically higher. The downsides are the expense—perhaps $10,000 for the egg freezing and an average of more than $12,000 per cycle for IVF—and having to use IVF to get pregnant. Women who already have a partner can, alternatively, freeze embryos, a more common procedure that also uses IVF technology.
At home, couples should recognize that having sex at the most fertile time of the cycle matters enormously, potentially making the difference between an easy conception in the bedroom and expensive fertility treatment in a clinic. Rothman’s study found that timing sex around ovulation narrowed the fertility gap between younger and older women. Women older than 35 who want to get pregnant should consider recapturing the glory of their 20‑something sex lives, or learning to predict ovulation by charting their cycles or using a fertility monitor.
I wish I had known all this back in the spring of 2002, when the media coverage of age and infertility was deafening. I did, though, find some relief from the smart women of Saturday Night Live.
“According to author Sylvia Hewlett, career women shouldn’t wait to have babies, because our fertility takes a steep drop-off after age 27,” Tina Fey said during a “Weekend Update” sketch. “And Sylvia’s right; I definitely should have had a baby when I was 27, living in Chicago over a biker bar, pulling down a cool $12,000 a year. That would have worked out great.” Rachel Dratch said, “Yeah. Sylvia, um, thanks for reminding me that I have to hurry up and have a baby. Uh, me and my four cats will get right on that.”
“My neighbor has this adorable, cute little Chinese baby that speaks Italian,” noted Amy Poehler. “So, you know, I’ll just buy one of those.” Maya Rudolph rounded out the rant: “Yeah, Sylvia, maybe your next book should tell men our age to stop playing Grand Theft Auto III and holding out for the chick fromAlias.” (“You’re not gonna get the chick from Alias,” Fey advised.)
Eleven years later, these four women have eight children among them, all but one born when they were older than 35. It’s good to be right.



Tuesday, June 18, 2013

This Is the Last Time I Will Ever See You

After every wedding, there is a dear friend who will immediately disappear from your life. And that’s OK.

Last night I was showing my daughter our wedding album, and I saw a ghost. There, grinning at me back at me from July 20, 1997, was a face that had once been as familiar to me as my brother’s.

“Who’s that?” my daughter asked.
“That’s Matt M.,” I replied.
“Who’s Matt M.?” she asked.
Who’s Matt M.? Once I had watched in awe as Matt—a polite, slow-talking Westerner—persuaded a furious cop not throw us out of the Bend, Ore., park where we were illegally camping. During the most terrifying hour of my life—a 3 a.m. drive through a Georgia hailstorm in a deathtrap Toyota—Matt sat calmly by my side in the passenger seat, switching up the mix tapes. I had seen him torn up by love, and he had seen me the same. He was the dearest of friends, and 16 years on, he was a stranger.
When you are in the throes of wedding planning—the epic, Iranian-nuke-level negotiations with your fiancée about invitations, the masterful diagramming of every possible seating permutation to maximize hookups and minimize family arguments—it seems inconceivable that somewhere in this group, the group of people that you are closest to in the entire world, the people with whom you will share the most extraordinary moment of your life, are dear friends you will never see again after your wedding day. You don’t know who the last-timers are—in fact, you can’t know—but they will be there on the dance floor and in photos. And suddenly, one day—two, five, 20 years on—you will think to yourself: I haven’t seen her since our wedding. And then: How did that happen?
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When I talk about last-timers, I don’t mean those old friends of your parents who got invited over your protests. Of course you’ll never see them again. I also don’t mean the various disposable plus-ones. Any wedding of any size will be populated by boyfriends, girlfriends, and even spouses who will have been dumped or divorced by the next time you see your friend. My brother-in-law’s then-fiancée is all over our wedding photos. She was on her last legs as a fiancée, but we didn’t know it at the time. Sweet, kind Liane: Where are you now?
No, the last-timers I’m talking about are real friends, but the friendship has entered a slow fade to black that is obscured by the euphoric fog of the wedding. Sometimes, geography is to blame. A decade ago, my wife Hanna attended the wedding of a friend who was marrying a Swede—and moving to Sweden. Hanna hasn’t seen her since. The ties that they might have maintained had they lived 200 miles apart frayed and finally split at 3,000 miles.
Another kind of last-timer is the friend that your spouse doesn’t really like. One of Hanna’s bridesmaids was an old friend I could never abide. As I courted Hanna, this friend and I pretended to tolerate each other. But after the wedding, when Hanna had picked her side (mine), and our social calendar was fully combined, this friend never quite made it on any list, and was never included at our newlywed dinner parties. Hanna discovered she didn’t care enough about her to overcome my dislike, and their friendship withered. For 16 years, we’ve lived and worked in the same city, and have never seen her. A bridesmaid!  
But the most poignant last-timers, the ones who really matter, are the people who once were profoundly important—stalwarts in a terrible time, co-adventurers, the dearest of dear—who, not because of geography or profession, but because of the eddying currents of life, are already drifting away from you by the time of the wedding, even if you don’t realize it. There is no break, just the conspiracy of inconveniences. You have a little less to talk about: Brian was once a journalist, but now is a businessman, plus he’s come out as gay, and is committing his time and energy to the love life he never had before. Matt’s living in a slightly far-flung city, and neither of you has the time or money to travel. You invite them to your wedding because—god, how could you NOT invite Matt or Brian to your wedding? The wedding draws them back. In the golden haze of the reception, your friendship feels restored to all that once was, but that’s the wedding mirage. The gap begins the next day.
If you had asked me on July 20, 1997: When’s the next time you’ll hang out with Matt? I would have guessed a year. Instead, it’s 16 and counting. Until yesterday, I hadn’t even Googled him.  I didn’t know where he was or what he was doing.
Wedding websites are skeptical of last-timers. The Knot insists that the very first people you should cut from your list are the “college friends you’re pretty sure you’ll never see again.” Another site—with a rather chilly utilitarianism—urges you to consider “who you will be friends with in the future [rather] than trying to include old friends you don’t keep in touch with.” This is, of course, very sensible advice. Why waste $200 in catering and calligraphy on people who are streaming toward the exit door of your life?
I reject this. For starters, you truly can’t be sure who the last-timers really are. The friends I haven’t seen since my wedding are not the ones I might have predicted. And even if you knew, as a matter of Euclidean certainty, who the last-timers were, you should still invite them. When, if not your wedding day, is the time for profligate, romantic gestures? What better way to end a friendship than with joy? What better than to have your final memory of each other be of your best, happiest wedding selves

Thanks: http://www.slate.com/articles/life/weddings/2013/06/wedding_guest_goodbyes_friendships_that_end_after_your_wedding.html?ico=home^editors_choice

Saturday, June 8, 2013

I was raped when I was 21, and I can tell you, Nick Ross - all unwanted sex is a violation, says FERN BRITTON as she hits back at Crimewatch founder's book

Fern Britton teeters into the room on stilt-like stilettos, self-consciously tugging the hem of her skintight Alexander McQueen mini dress. She looks radiant. Seven years after controversially losing five stones with the aid of a gastric band, she still enjoys showing off an hourglass figure.
‘I think it’s important that women are able to dress the way they wish to dress,’ says the former Good Morning television presenter. ‘If I want to wear a short skirt, then I’m going to.’
She is, of course, correct. Simply because a woman wears figure-hugging or revealing clothes, she shouldn’t be accused of  inviting unwelcome attention. And that is a subject with which Fern is all too familiar.

All week an argument has raged over Nick Ross’s controversial remarks in his new book, Crime, serialised in The Mail on Sunday.
Discussing the incendiary issue of rape, he pointed out that ‘not even in the licentious days of Charles II in the 17th Century was it acceptable for women to dress as provocatively as they have done in Western culture since the 1960s.’
Predictably, his analysis provoked outrage – and some degree of support, too – when he reported that, for some women at least, ‘rape isn’t always rape’. 
While the offence is always reprehensible, he said, some women must take a share of responsibility for what happened to them.
Fern, 55, is well-qualified to contribute to this difficult debate. She knows from bitter personal experience the dilemma many women face after suffering the traumatic ordeal of a sexual assault.
At 21 she was raped in her home by a man who had asked her on a date. She didn’t report it to police because she felt she had been at fault.
She chooses her words with care. ‘Nick’s a great guy, but he’s not a woman... he’s not somebody who has been invaded in a way that he didn’t wish to be invaded.The fact is that rape is rape. If you don’t want it, but someone does it against your wish, then it is  a violation.

‘Even if you get a bit drunk or if you go back to the person’s flat, once you say no then it’s no.
‘In my case I was stone cold sober. The man came to my flat and didn’t want to leave, even when I told him to. He was someone I had recently met and who had come to pick me up and take me to dinner.
‘Afterwards I shut down. I didn’t want anyone to know about it. I just wanted to pretend it never happened.’
It was an act of kindness when she was living in Cambridge that led to the terrifying attack.

She had taken two lost dogs to a police station and their owner had obtained her phone number to say thank you.
The man seemed ‘pleasant and nice’ and she accepted his invitation to dine out – twice. On the second occasion he arrived at her flat to pick her up bearing two bottles of champagne. She took them to the fridge and when she returned to the living room, he was doing press-ups wearing only his underwear.
‘My first thought was that it was a joke, but within seconds my ha-ha! turned into Oh God,’ she later wrote.
‘I didn’t have a phone at the flat, mobiles hadn’t been invented, and before I knew what was happening he was up on his feet and trying to kiss me – pushing me against the wall, then down on to the floor. I was absolutely terrified and thought, “I’m done for – what do I do?” She said no, but he overpowered her.
The attack lasted all night and in the morning the man dressed and left. Fern did not speak publicly about it until she included it in her memoirs in 2008.
She didn’t report the attack to the police because she felt she had put herself in a dangerous position by letting a stranger into her flat and because: ‘I didn’t have bruises and he didn’t hit me.’
The trauma remained with her for years. ‘I didn’t  go out with a man  for a very long time. I shut it out, blocked it from my mind and got on with my life. I didn’t tell anyone.
‘Somehow you can still feel guilty. I felt that I should have done something. I think the majority of women who find themselves in a situation where something happens that they didn’t want, even if it was not full-blown rape, they won’t report it.’
It took many years for her to understand that she had been raped and it wasn’t her fault. ‘I didn’t have any therapy. I just put it down to experience, learned from it and moved on,’ she adds.
It’s not a response she advocates for everyone but she says it’s time women stopped seeing themselves simply as victims.
‘We must all take some responsibility for our actions. When you’re very young you don’t know the message you’re sending. You don’t know you’re sexually attractive, but the messages are being received.’
Younger women, she insists, should be aware of how they are perceived and the situations they find themselves in – a point with which, as it happens, Ross would very much agree.
Now the author of seven books – three on cookery, one autobiography and three novels – Fern has concentrated on her writing career since leaving daytime television in 2009.
We meet in a hotel in Powys, Wales, where she is promoting her third fictional work, The Holiday Home, at a literary lunch organised by Good Housekeeping magazine.
She is due back on television this month in a new ITV series, Secrets From The Workhouse, in which celebrities discover ancestors from the wrong side of the tracks. 
Fern was devastated to find out that her maternal great, great, great grandfather, Friend Carter, scraped a living working on the land but was forced to enter the workhouse to get free medical treatment when his son, Jesse, was taken ill.
Jesse was then sent to a teaching hospital, where he died and his body was given up for dissection as the family could not afford a funeral.
She was distraught to learn of her relatives’ struggle to make ends meet and the harsh conditions they faced. Friend Carter found himself back in the workhouse at the age of 91, shortly before he died.

The experience has left her thinking more about her own mortality and the way society views death.  Most people, she says, are in denial about the end of life.
‘We don’t want to talk about it and we don’t plan for it. The trouble is that medicine has told us that we can beat anything, live longer and  stay young forever.’
She thinks death should be embraced and has planned her own funeral. ‘It’s all written down in my will and the kids have been briefed,’ says Fern. ‘After the service, I want to be cremated and my ashes tipped from a speedboat off the coast of Cornwall on a moonlight night out over the waves. The boat and urn must be covered by lots of fairy lights, because I love fairy lights.’
Friend Carter would be proud to know that his descendants went on to prosper.
Sitcom actor Tony Britton is Fern’s father and her mother Ruth was also an actress. Fern’s TV career began as a continuity announcer in Plymouth for Westward TV more than 30 years ago. Since then she has presented BBC’s Breakfast Time, GMTV, London News Network’s London Tonight, Ready Steady Cook and This Morning.
Fern, who is rumoured to have left This Morning after discovering that co-presenter  Phillip Schofield was getting paid more than her, is keen for people to realise she is a more than a friendly, smiling face.
‘People think I’m just a silly old girl next door, but I do have a brain. I’m no Stephen Hawking, but I’m a member of Mensa and I have a doctorate for services to broadcasting from Buckinghamshire New University. All right it’s honorary, but I’m a doctor.’
Such things, she says, give her a ‘quiet internal boost’ because she feels she squandered her years in school and never went to university. It is her family, however, that provides the essential ballast in her life, especially her husband, chef Phil Vickery, 52. They have been married for 13 years and share their sprawling Buckinghamshire home with their daughter Winnie, 11, and Fern’s children by her previous marriage, twins Jack and Harry, 18, and daughter Grace, 16.
The couple met while working on Ready Steady Cook.
‘It was fabulous to have found someone I was hopelessly in love with and who was prepared to take on a divorced woman with three children. He’s very loving, funny and great with the kids. He’s my best mate.’ But does the comfort of domesticity match the excitement of live television? She smiles and replies with a pragmatism that suggests she knew it was time to move on after more than 30 years of daily television appearances.
‘Honestly, I don’t have hunger to return to that. I think that when you’ve had your turn then you’ve got to let somebody else have a turn,’ she says. While agreeing that some men have a longer turn than women, she insists that a lot don’t. 
‘Of course it’s not fair that once women start knocking on a bit their experience is kicked out the door. But then women are usually more pragmatic and we have lives that mean we don’t need the constant attention from work. I’m really still productive in so many other ways.’
Age and life experiences have brought confidence and contentment. But it took Fern many years and much personal anguish to come to terms with the assault she suffered as an innocent young woman. Yet she still thinks her decision not to go to the authorities after her rape was the right one for her.
Secrets From The  Workhouse, ITV, June 25

Saturday, June 1, 2013

FYI: What Is The Limit To How Fast A Human Can Run?

The limit to how fast a human can run is 9.48 seconds for the 100-meter race, 0.10 seconds faster than Usain Bolt’s current world record, according to Stanford biologist Mark Denny. That is, if you are talking about natural human beings.
In a 2008 study published in the Journal of Experimental Biology, Denny modeled the fastest human running speed using records of men’s 100-meter race results going back to the 1900s. Denny plotted the annual best times in the race into a graph and used computer programs to come up with an equation whose curve best models the behavior of the actual graph he obtained. The curve showed humanly achievable time for the 100-meter race would level off at 9.48 seconds. “They haven't plateaued yet, but you can definitely see the data are bending a little towards that plateau,” Denny says.

Denny, who also modeled the best times for racing thoroughbreds and greyhounds in the same study, found there’s a speed limit for these races as well, with little improvement in the Kentucky Derby since the 1950s and dogs’ performances leveling off in the 1970s.
“If you look at other species — ones that we're trying to breed to run faster and faster — it's not working,” he says. “There's no reason to think that human beings are any different from the other species, that somehow these things don't have limits.”
Statistical models do not explain the mechanics behind running. So Peter Weyand, a biomechanics professor at Southern Methodist University, has taken a different approach to the question.
A leading expert in human locomotion, Weyand says the primary factor influencing speed is how much force sprinters hit the ground with their feet.
When athletes run at a constant speed, they use their limbs like pogo sticks, Weyand says. Once a sprinter hits the ground, his limb compresses and gets him ready to rebound. When he’s in the air, the feet get ready to hit the ground again.
When a runner hits the ground, 90 percent of the force goes vertically to push him up again, while only 5 percent propels him horizontally. In that regard, sprinters behave a lot like a super ball, Weyand says. “What they do is they bounce a lot,” he says.
Our body naturally adjusts how fast we run by changing how hard we hit the ground. The harder we hit the ground, the faster we go.
So just how hard can humans hit the ground while they run?
In a 2010 study published in the Journal of Applied Physiology, Weyand and four other scientists had runners running on treadmills at a constant speed in different gaits –- running forward, backward, and hopping. Their study finds that when we hop, our limbs hit the ground with 30 percent more force than when we run, primarily because the foot stays much longer in the air. Based on that information, Weyand and his team calculated that in theory, human beings can run as fast as 19.3 meters per second — that is, if they hit the ground with the maximum force physiologically possible. If a sprinter were to run at that speed throughout the 100-meter race, he would finish in 5.18 seconds.
But that’s not the end of the story. In a new study to be published this year, Weyand and his team have found that maximizing running speed requires a tradeoff between hitting the ground hard and maintaining stride frequency. Hitting the ground with maximum force requires the sprinter to spend more time in the air, which slows down the strides he can make per second. The optimal combination of stride frequency and ground force varies with individuals depending on their size, leg length, and the speed they run, Weyand says. There is no golden ratio.
So what’s the fastest human running speed possible under this new model? Weyand is reluctant to give a definite number. “Science is not good at making predictions of extremes,” he says.
Nonetheless, he says he wouldn’t take 9 seconds for men’s 100-meter race off the table. “Something in the low 9s is definitely possible, perhaps faster,” he says.
That speed still won’t allow us to outrun an adult cheetah, the fastest land mammal, which can cover 100 meters in less than 6 seconds.
Science and technology are changing the limits to human running speed. Athletes nowadays can take hormone doses to change the mechanical properties of muscles, and scientists have succeeded in tweaking mice’s DNAs to alter their muscle fibers.
“We're sort of moving into a Brave New World in athletics where there are many many different types of performance enhancement avenues available,” Weyand says. “What's happening is that identifying what's natural and what's not natural is becoming increasingly blurry. To me, (to answer) what's the ultimate speed somebody can run, we now have to go through a list of 10 different conditions: are we talking about no gene doping, no special technology, no pharmaceutical agents … But as we go further and further along there's even potential for tracking shoe design to change speed. It starts to become a horribly complicated question.”

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