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December Baby

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In hindsight,  it’s a good thing I didn’t go to my 39-week OB appointment alone; I don’t think GP would have believed me when I returned home and told him we were going to have a baby in the next 36 hours or so. As it happened,  he was there,  sitting next to me as my doctor told me that,  because my blood pressure had been consistently high for much of my pregnancy and because I was full-term,  she wanted to go ahead and induce.  At first, I thought she’d set us up to go to the hospital the following week (this conversation happened Friday afternoon),  but nope,  we’d head over that night. So, we heard home to panic a little,  finish packing our bags, and take one last shower before approaching the desk in L&D and telling them we were there to have a baby.  (Yes,  totally nonchalant, not at all the way I expected.)

My doctor had been able to get me admitted because of pre-eclampsia (though I never had any proteinuria…you’re welcome for that detail), which meant that a cavalcade of drugs was in my near future. First came a beta blocker, then the magnesium sulfate, and then the Cervidil to soften my cervix (the insertion of which was…not a treat). Aside from 20-30 minutes during which I felt like hot garbage because of the magnesium, these weren’t so bad. The Cervidil needed 12 hours to work,  so they told us to get some sleep. GP and I stretched out on our respective beds (both uncomfortable,  but it was easier said than done, for sure.

The next morning,  the Cervidil had done its work and it was time for Pitocin. I’d heard alarming things about Pitocin contractions (intense, and with small breaks in between), but I had no frame of reference for contractions, so I was ready to roll without an epidural for as long as I could stand it. As it turned out, I was able to go about 4 hours before I accepted the fentanyl that was offered as a temporary relief, then finally had the epidural put in not long after (maybe 2 hours or so). With the epidural in, I was still aware of contractions but wasn’t crippled by them; the nurses advised us to get some sleep– the big show wasn’t too far off now.

After a nap (oh, I was so grateful for that nap!), I woke up and was told I was complete,  so I could start pushing anytime I was ready. My doctor had arrived, and she, a nurse,  and GP would coach me through the delivery of our daughter. Aside from a few weird interruptions in the epidural line– during which I was so distracted by pain that I count focus on pushing– I would say that this was the most… satisfying (?) part. They wheeled in a mirror so I could see what was going on (an idea which had previously seemed sort of gross to me), and that was a huge motivator. At one point, when we could first see her head (and all that hair!), my doctor told me to reach down and feel my baby’s head. I did, and it was still entirely surreal that any of this was happening.

We had a good laugh when my doctor suggested she might be a redhead, like me. (“Oh, that’s not your natural color?”) And, eventually, we’d done the old three-big-pushes-per-contraction routine enough to deliver the head, and her body tumbled out immediately after. I was vaguely aware of them suctioning out her nose and mouth, and I remember hearing her cry for the first time. (GP confessed to some worry because she was a little blue at first, but she pinked right up and had 9/9 Apgars.) I lost a fair (but not concerning) amount of blood, but was fine after chewing some Cytotec (more drugs, please), and got to “enjoy” the “vigorous massage” administered to help my uterus contract.

I had expected that I would be completely overcome with emotion and absolutely sobbing by the time they placed her on my chest; instead, we just looked at each other. It seemed (and still sort of seems) impossible that she was finally here, this person that I already knew so well,  but was only meeting for the first time.

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Now that she’s been here for over two weeks,  it’s already impossible to remember what life was like before her. Sure,  my life at the moment is loved in roughly three-hour increments, but I wouldn’t have it any other way.

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Rather

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Once it became clear that there was something going awry with my previously calm pregnancy, I began to mentally prepare for the worst. It was as agonizing as you might imagine, but also involved the thought, “If this goes as poorly as it could…I’m going to need a major fucking vacation.” This was helpful (and has continued to be) because it gave me a sense of a happy future even without the baby we were so anxiously anticipating. Sure, maybe it wasn’t a vision of what the everyday would be like– convince yourself to get out of bed, smile and interact with people appropriately, truly appreciate what a supportive network of family, friends, coworkers, and internet strangers you have– but just imagining this escape was, for a time, escape enough.

When we got the official diagnosis, one of the things that GP said to me was, “Let’s go away. Like, far away.” Mind you, this happened without any suggestion from me that we might want to skip town to momentarily take our minds off All the Terrible; it was a good reminder that I married exactly the right man.

And so, just under a week from today, we’ll take that Big Fucking Trip to a Faraway Place. We’re going to be spending about two and a half weeks in Hong Kong and Thailand, courtesy of our joint wanderlust, my company’s generous PTO-donation program, and a desire to be far away from home when the day that was to be my due date passes. Yes, rather than finishing up a nursery and fighting for some decent sleep, I’ll be spending about sixteen hours on an A380,  getting a couple more stamps on my passport, and living the shit out of my (currently baby-free, as the doctor said to wait six effing months) present.

 

Hum

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When it became clear that we had something to worry about, rather than sailing smoothly to a healthy baby, the alarm bells wouldn’t stop their clanging and my inner monologue was a constant shriek of panic. The moments where I felt like I could relax were, unsurprisingly, few and far between. I couldn’t focus on anything but the noise in my head, the constant terror that something was going horribly awry and there was nothing I could do about it.

Now, just over five weeks from our initial diagnosis, the first red flag, and just over three weeks from a goodbye that we didn’t want to have to say…that alarm is down to a low hum, and the monologue is quieter, though still constant. Rather than the paralyzing dread that I felt for weeks on end, this is a quieter sadness, one that has crept in and made itself at home. It’s not going anywhere any time soon, but I appreciate that it’s a less intrusive tenant, one that doesn’t try to get in the way when I find comfort in friends and family, in the idea that happiness hasn’t disappeared, in hope for the future.

Ready to talk about it

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Before beginning what will likely be the longest blog entry since I started writing in 2002 (a decade of blogging makes me feel hopelessly old), I have to say how truly grateful I am for the support and love from all corners of the internet. While I have of course been shown the true depths of empathy that exist in my friends, family, and coworkers (really, I can probably never convey how much that has meant to me), it strikes me how many messages of support I’ve gotten from people that I have never even met. Sure, we follow each others comings and goings via feed readers and social media, but realizing that there are people in the world that– really, no-foolin’– are ready to hold you up through the Actual Worst Thing That’s Ever Happened to You…is pretty wonderful. Thanks, you guys. Thank you so, so much.

So, the beginning. The “beginning” of this whole process was our anatomy scan, which was done when I was exactly 19 weeks along. GP and I headed to the practice recommended by my usual OB, a practice with a high-resolution ultrasound machine that would show us how our baby’s organs were developing, and that would allow us (provided the baby was cooperative!) to find out its sex. We were excited to see the baby again, as the prior two ultrasounds had been nothing short of thrilling. Heck, even hearing the baby’s heartbeat on the Doppler at routine doctor visits was amazing. We waited for a little while, catching a few minutes of Live With Kelly and Michael (“Michael Strahan is so charming!” exclaimed GP), then making our way back to the room where we’d get to see our baby again.

The first thing we found out was that it was a boy– we were enthused about finally finding out the sex, but not necessarily more or less excited to hear “boy” rather than “girl.” I felt validated because I had had a dream that the baby was a boy (you know, a totally reliable way to predict your baby’s sex), whereas GP had had a dream in which the baby was…a kitten. (So I sort of knew that I had a greater chance of being right, anyway.) The tech went through the rest of his measurements, noting that the spine, kidneys, etc looked fine. There was an issue in the way that the baby was positioned– such that the tech couldn’t get a good look at the heart or brain– so a doctor was sent in. That’s where things started to go downhill. After GP and I had discussed the implications of our baby being a boy (“He is not allowed to play football!” “He can take dance classes if he wants to.”), we fell silent as the doctor spent what felt like an eternity looking at the heart; we could see it beating on the large screen in a corner of the room.

“What I’m seeing,” said the doctor, “is that the heart isn’t divided into four chambers as it should be. I’m also seeing some cysts in the brain, and I’m concerned about the position of the fingers.” She went on to explain that the heart defect she saw (atrio-ventricular septal defect) was perfectly operable (and people who have this corrective surgery as babies live long, healthy lives), but that it, along with the brain cysts and finger positioning, could be a marker for genetic anomalies like Down syndrome and others. After answering our questions, she left us in the darkened room to absorb this news about our son.

It was just under a week between our first and second appointments. During this time, I had my second trimester blood screen done and learned that I had a whole slew of newly high-risk results, after a completely clear first trimester screen: there was a 1 in 110 chance of trisomy 18 (three copies of the chromosome rather than the usual two), a 1 in 88 chance of Smith-Lemli-Opitz syndrome (something that my regular OB, in sharing the results with me, confessed that she had never seen), and a 1 in 70 chance of Down syndrome. Given these odds, we were thrown into a flurry of research. What would it mean if our son had one or more of these genetic problems? What choices would we be able to make about my pregnancy, and what impacts would they have on all three of our lives?

We spoke to a genetic counselor at our second visit and discussed what the presence of genetic anomalies would mean, mentally and physically, for our baby. We also had another ultrasound, where we learned that the previously-seen AVSD wasn’t actually there (a small relief, sure), but the brain cysts and hand deformities were still present. I knew, after receiving the blood results earlier in the week, that I wanted to do an amnio in order to have definitive information about our son. Rather than having to wait for another appointment, we were able to do it right there, with a promise that we’d have preliminary results within a few days. As we wrapped up the appointment, the doctor asked us if we’d thought about what we’d do if the results for any of the genetic defects came back positive. Because we had talked about it, discussed and agonized over our potential decisions, I responded that we would likely choose to end the pregnancy rather than attempting to go full term and cope with what would likely be very severe mental and physical handicaps.

That weekend, we went to the wedding of a couple close friends– the groom had been one of GP’s best men, and GP was returning the favor. As I sat in the church with my in-laws (also in town for the wedding), watching our friends get married, I thought about the lives that GP and I had created for ourselves, the small, happy universe of our marriage. We accepted congratulations from friends on our expanding family, keeping inside our growing fears that everything was crashing down around us. I never thought I would be so dependent on what seemed like a word problem from the world’s worst math class– I wanted to be one of the 109, one of the 87, one of the 69 women whose baby is prefectly genetically fine. I wanted to be sure that our son’s life would be long, happy, and healthy…and I knew that the odds were slim on all of those.

I got the call on a Monday, at about 10:30 in the morning. I jumped when the phone rang, raced to the atrium in my office’s building, and seated myself on the edge of a planter as a genetic counselor told me that my son had trisomy 18. Having researched all the possible results of the amnio, I knew what this meant. (Go ahead, Google it. I’ll wait.) I had an appointment with my regular OB the following day, and went ahead and made another at the practice where we’d had the amnio– we’d be able to speak with a genetic counselor again, as well as a doctor to discuss our options. I don’t know how I managed to breathe as I told my boss that I needed to leave, now.  I don’t know how I made the drive over the hill from work back home. I don’t know how I managed to hold my body together as I walked into the house and made my way to GP. I didn’t– and still don’t– know how we got where we are now.

The counselors and doctors were supportive as we agonized over the decision to end my pregnancy, a decision that was the last one GP and I were able to make as parents of our first son. Having as much information as we could gather about our trisomy 18 diagnosis, we felt as though the decision was one we made to protect our son from a short life full of pain and medical intervention, despite the fact that it was one that completely broke our hearts. Not wanting to have my first experience with labor to be one that did not end in carrying a healthy baby out of the hospital, I chose to have a D&E, which was a two day process. Early in the morning of the second day, GP and I headed to the hospital, where I would be put under a general anesthesia and have our baby boy taken from my body. It would be at once redundant and hopelessly inadequate to say that this day, and the weeks that preceded it, were the hardest of our lives.

I know I’ll write more about this whole process, the moments and months that add up to a life-changing loss. Both because I know I can count on the support of family, friends, and strangers and because I want to add my story, my voice, to the legion of women whose pregnancies have ended, either by agonizing choice or chance, I will write more about this. Because writing about things is so often my way of working through things, of coping with them, and in this more than just about anything in my life at the moment, I need a place to work this out.

Empty

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There’s no logical reason that I should be extra-sad today. A week seems like an arbitrary marker of time for the loss I feel, but yet…there it is.

We said goodbye to our baby (a boy, by the way) a week ago today. I’m not ready to write about it (and have vowed to write something for myself first), but having those 18-week pictures up at the top seemed like too much of a gut-punch to bear.