12 years

I’ve thought often about what memories of my mother I’ll share with N.  It seems such a daunting task.  How can you ever convey the entirety of an entire beautiful (if brief) life in a few words?  Express all that energetic love in a single story?

So today, on the 12th anniversary of her death, I want to jot a few down for posterity:

  • She woke me up at 4:35am every single birthday.  She’d say, “Welcome to the world my darling daughter!” and I’d glare sleepily at her with as much scorn as a 7-year old could muster.  We’d almost always grab a birthday breakfast at a diner chain soon after.
  • She loved Christmas.  And decorations.  And tradition.  It was sacrosanct.  The Thanksgiving feast would start with a Christmas-themed present on my dining room chair, after we’d spent the afternoon as the turkey cooked wrapping the Christmas presents she’d always have fully purchased before Thanksgiving.  The decorating, tree cutting, house trimming, cookie baking, and light-hanging would continue on for the rest of the weekend.
  • She woke up early.  4:30am was late.  She’d get more done before dawn than most did in entire days.  She didn’t pass that vim and vigor on to me.
  • She always fell asleep with her TV on.  I’d sneak into her room and be the “TV fairy” and turn it off for the night, before I – night owl already at age 10 – would settle in for the night.
  • She loved me “’round the world and back again.”  Just as I love N.
  • She had a truly inspired way of making games out of tasks most could wouldn’t want to do.
  • She was fiercely protective of her only child, and defended my perfection to any who’d doubt it.  Sometimes her loyalty was well-earned, other times, she gave it to me in error.  Knowing she always stood behind me, though, made me strive to always prove her right.  I never wanted her to be wrong.
  • She was the embodiment of her red convertible.  Loud, but not offensive.  Proud, but not boastful.  Conspicuous, yes, but never flagrant.  How many nights we spent staring at the stars, reclined in those seats, listening to “our song.”

Ultimately, though, I know none of the items above will even come close to cutting it.  But, in the process of jotting them all down and tweeting with another IFer I had one final memory.  My mom would always get a little strange each February.  I don’t know how early on in our young lives we can tell when another human seems in distress, but I felt it annually from that point forward.  I’d never find her weeping in a corner, or losing her temper, or anything nearly that obvious.  I’d just silently sense her pain.  Her eyes would be duller, her ready laugh a little less genuine, her pep a little less present.  In retrospect, she’d act like a muted down version of how she’d act in the pain-med-addled final days of her battle with cancer.  She’d just cease to be my mom.

Somewhere in my mid teen years I got interested in genealogy.  Something about having so many dead immediate relatives, I think.  Anyway, I started asking about family statistics – birth and death dates, ages, places of birth, yadda, yadda.  That’s when I realized it.  My mom’s dad – my grandfather I could barely remember – died in February.  It clicked in an instant.  In that moment I knew the love she’d felt for that man more than I’d ever garnered from countless stories and anecdotes.  Her grief changed her mentally and physically.  A change so major even an self-centered 8 year old noted it.  This man must have been special.  This man really mattered.

I’m not thrilled at repeating this process, of having N intuit my pain so young, but I can only hope his conclusions are ultimately the same as mine.  That he one day knows both the anecdotes and visceral reactions her loss has had on me.  And that mom’s pain underscores the power of the grandma he’ll never know.

Can you laugh your way into the looney bin?

The prospect of updating this space with news of the past 2 months makes me cringe.  How can you possibly fit all that joy and sadness, bliss and stress into an empty textbox?  When I started this blog it had one purpose.  To provide a space to scream loudly, cry publicly, type angrily about infertility.  Infertility.  That disease we so frequently suffer in silence.  That disease we still so frequently have to convince people is a disease.

Cancer’s not nearly so silent.  Yet, two months in to losing my second parent to cancer, I sit here silently.  It’s too much to type.  It’s too much to fathom.  It’s much too much to manage.

So, we’ll start with a story.  A single event.  And an event that’s even loosely tied to infertility when we’re all said and done.  Now lookey there!

I got my period on Tuesday.  The first since August 2013.  The first since IVF, since pregnancy, since the arrival of N, since my dad’s cancer diagnosis and craniotomy, since waving the white flag to breastfeeding with an insufficient supply and dying dad 7 hours from home.

When I pulled the toilet paper up to inspect it (will this nervous tick IF and multiple miscarriages ingrained in to me ever go away?), I saw the red.  When I saw that red I laughed.  I laughed a laugh so hard I shook.  I shook so hard I laughed some more.  At some point the laughter transitioned to screams of misery and tears of terror.  My face went numb, I laugh-cried, I fell to my knees.  This was it.  This was my breaking point.  This was surely the moment I wouldn’t recover from.

*******

30 seconds prior to that wipe, my husband was holding a fussy N and answering my father’s home telephone.  He was screaming to me, “It’s your aunt.  She wants an update on your dad.”

1 minute prior I was walking through the door of my father’s house with sushi takeout in hand.  I was greeting my husband and son, ready to settle in for a late dinner after a hectic day.  I said to my husband, “I really need to call my aunt and update her, but I haven’t peed since noon and I’m going to wet my pants if I don’t take 30 seconds to do this first!”

30 minutes prior I was driving in my car with my husband and son discussing how upside down the day had gone, how hungry we both were, and how much we needed to just get some takeout and relax for the rest of the night.  I was handing my husband my phone to call in my spicy tuna roll while I drove home from our errands.  I made plans to drop off the boys, let the hubby get a headstart on N’s bottle, bath, and bed routine, and go retrieve our food.

1 hour prior I was sitting in the Target parking lot with a fussy N in the back seat waiting for the hubs to return from getting the special AR formula my refluxey, fully formula fed baby now needed.

1 hours and 30 minutes prior I was standing in the aisles of Sam’s Club cursing them for not having N’s formula.  I silently mourned again the loss of the breastfeeding relationship I thought I’d have with my much longed-for child, but I quickly moved back to our mission.  More diapers and formula.  We’d be staying in town for longer than planned. We’d need more diapers.  More formula.  Feed the baby.  Change the baby.  Love the baby.  Don’t be so stressed when plans keep on changing.  We’d still have our Thanksgiving feast.  Dad’s would just be reheated in the microwave and served on a hospital tray.  We’d sneak N in in his adorable bow tie to cuddle with grandpa.

3 hours prior I was standing in the hallway of my hometown hospital listening to my dad’s quirky (aka obnoxious) oncologist utter the words, “He’s a tough old bird.”  No, he didn’t really know how this affected prognosis.  No, he didn’t know what the next few days would look like.  No, he didn’t know much.  “You see,” he’d said, “I don’t really know what to tell you.  I’ve only ever seen blood clots this bad mentioned on autopsy reports.  I don’t really know how he’s still with us.”  He literally has a clot floating in his heart.  Bouncing around with every heartbeat.  How is that even possible?  Ok, change of plans.  Not home for Thanksgiving.  Not home for a while.

4 hours prior I was sitting by my dad’s hospital bed explaining that we weren’t dooming him to live the rest of his life in a hospital.  I was explaining as simply as I could that there were two different things the doctors were talking about.  “Two separate things,” I’d said.  “There’s cancer and there’s blood clots.  You’ve got both.  One caused the other, but they’re separate.  You’re here because of the blood clots, and only here until we get over the hurdle with these blood clots.  You’re not here because of the cancer.”  When dad asked, “Then what the hell’s wrong with this doctor?  Why’s he so negative.  He had me thinking I was going to die!” I had to respond – again – “Dad, you ARE going to die.  The cancer will kill you someday.  Probably someday in the next 12 months to 2 years.  You’re here because the blood clots almost killed you.  And, they almost killed you yesterday.”

5 hours prior I was screaming at my husband that the fucking nurses station had me on hold for over ten minutes.  My dad could be dying right this minute and they’d put me on hold.  Then they hung up on me.  I was livid.  I called back, said I’d be there in 10 minutes, and I expected the doctor to be there waiting to talk to me.

5 hours and 10 minutes prior I was just taking my jacket off when my dad called from his hospital bed.  “I’m really confused and upset,” he said.  “This doctor came in.  I don’t know who he was.  Things are very negative right now.  He’s very negative.  Something very bad is happening.  Something with my test this morning.  I think he thinks I’m dying.  I don’t know what’s going on.”  I cursed again a cancer that manifests as transient confusion akin to Alzheimer’s.  I cursed again a doctor speaking to my dad without me being present.

5 hours and 20 minutes prior I was just settling in after returning home from visiting my dad and doing a giant grocery shopping trip.  The emergency room doctor the day before had said he could maybe be home by Thanksgiving.  I went straight from the hospital to the store, buying all things turkey and pumpkin.  We’d have a real feast.  My dad’s last, and N’s first.  If we were going to miss our usual big family holiday with the in-laws, we were at least going to gorge on turkey and make sure my dad enjoyed our visit.  All we needed to hear was that the echo they’d done that morning was clear.  He was obviously strong to survive so many clots.  To walk into the ER with a pulmonary embolism and only be complaining of a little shortness of breath.  A clear echo, a prescription for blood thinners, and we’d have our Happy Thanksgiving.

6 hours prior I was pulling out of the hospital parking garage feeling relieved.  Dad was in good spirits and less confused today.  He’d even been pleasant with the ultrasound tech.  Maybe I’m too used to reading the expressions on tech’s faces for my own good after more scans – internal and external – than I can count.  But, didn’t that echo take an awful long time?  Didn’t that tech get really silent?

*********

When I wiped red all I could think about was the day.  Not the emotions of it – the ups and downs, the bad news the good, the baby giggles and the terror in my dad’s weak voice.  I zeroed in on the places.  The grocery store.  Sam’s Club.  Target.  The Rite Aid next to the takeout restaurant.  They all had pads and tampons.  I didn’t.  Not a one.  I waded up some toilet paper, shoved it down my underwear, kissed baby and hubby goodbye, and drove to the Rite Aid.  My eyes were red and raw, I stumbled around like the drunk my dad was before cancer.  My laughter on the toilet echoed through my head.

As the clerk rang up my goods – value pack of tampons, pads, 500-count Advil, and, of course, a Hershey’s bar – I thought to myself, “Well, the day could have been worse, I suppose.  I could have run into someone from high school here in the pharmacy.  Doesn’t that always happen when you’re home for the holidays?  Dodged a bullet there.”

When life laughs last…

I was looking forward to living life beyond my maladies.  To comprehend life outside of surgeries, losses, and waiting rooms.  To embrace an IF-less life.

On Monday I became the daughter of a dying parent.  I fill this role for a second time.  My world is spinning and staying still at the same time.  Can you be called an orphan at 31?

Glioblastoma multiforme.  Stage IV brain cancer.

My dad was picking the wrong words the weekend of September 6.  The eggs became gravy; the gasoline a motor.  I diagnosed alcoholism-induced dementia, but made his sister promise a prompt visit with the GP.  The GP that apparently retired a decade ago.  My dad’s never had use for a doctor.  Fit as a fiddle aside from that drinking thing.  73 and healthy.  Hair just getting a silver sheen in these past few years, still mowing the lawn, fixing everyone else’s discarded lawn equipment, growing tomatoes from seed, drumming and marching as he did in the Air Force.  Ten days later when a new practice had time for him he saw a doctor.  At this point my phone conversations from 6.5 hours away were one sided.  “Dad, how are you feeling?”  Him: “Well, you know… you know… the tugboat.”

His sister called that night to say the doctor was very concerned and she’d taken his car keys.  That’s when I got scared.  My dad would never let his van keys be taken away.  Ever.

Two days later and time for the precautionary CT scan.  2.5 inch mass pressing out all the free space on the right half of his brain.  The scan and later MRIs look like a bad science fiction movie.  I’m certain you don’t need years of education in radiology to interpret that…

The night of the CT scan, my dad’s first night in the big city hospital, I tossed and turned in bed until little N woke for his 4am feeding.  We were in the car and on the road home – just two hearty travelers – by 5am.  I spent 8 hours with my dad, 10 hours away from my son, that day.  Two sentences made sense.

After months of crying over my inability to exclusively breastfeed, I cursed my body on the day of dad’s surgery.  I sat and wept in the hospital lactation room as I pumped for relief as my dad lay on the table.  17 hours away from N that day.  17 hours feeling like there was no way to succeed at motherhood and daughterhood at the same time.  17 hours waiting to hear that they got *most* of the mass, but not all.  That the mass was “suckable” but bad.  That it definitely looked like cancer.

Monday the pathology confirmed it.  With chemotherapy and radiation prognosis is 14 to 15 months.  He could have up to 2 years.  At least, I thought, one of those measurements comes in years.  My mom survived 14 months.  Will dad do better or worse?  Will I find myself hoping it passes quickly, or that we can milk each moment.

N won’t know his grandfather, just like he won’t know his grandma C.  How can N know me without knowing them?

I remember sitting in the backseat of my mom’s car, riding along with a little friend to dance lessons, or mini golf, or something.  She was talking about how her grandma did something, or cooked something, or smelled like something.  It’s vague.  I told her with the pride of a child, “I don’t have any grandparents!”  I remember my mom sniffling from the drivers’ seat.  Will I do the same when N innocently says, “Well, I only have Grammy and Pop Pop D.”

Most of the time I feel like an event planner or a fledgling bride.  Instead of calling caterers and venues, I’m dialing social workers and radiation oncologists.  Dad wants to be home, freed from rehab, able to tinker with cars and lawnmowers, able to cook.  I want that for him, but know he’s not who he was a month ago.  I need to hire a home aid.  I need to find transportation to radiation.  I need to get him cleared to leave rehab.  I need to do so much.  And in doing so much I never feel.  Feelings are for later.  If I remember how.  I’m not sure I do.

Failure to Thrive

This post has been a long time coming.  It’s also going to hurt to write.  But it will also help explain my sparseness in posting since Baby ButIF’s appearance.

I’m pretty sure that if you went back and read through a lot of my pregnancy posts you’d catch me saying here and there, “if I’m able to breastfeed,” or, “I talked with my counselor about ways to overcome my disappointment if I can’t breastfeed,” or even, “With PCOS and thyroid disease I’m pretty sure breastfeeding’s gonna be a total crapshoot.”  So, yea, I knew the cards were stacked against me.  Just as surely as my F-ed up hormones made it damned near impossible to get and stay pregnant, I knew they could also make breastfeeding a challenge.

Rather than be fatalistic about it, I thought I was being rational and proactive in preparing coping strategies in advance.  Though I have endless angst over it, I’ve become used to my body not working quite right.  At least, I thought, I could put that hard-won knowledge to use and spend some time – say 9 months – setting my expectations.  So, as the months of my pregnancy went on and my breasts failed to change one single bit I was pretty certain I was getting my answer.  We’d go to the hospital, I’d deliver, I’d skin-to-skin and attempt to feed him, I’d fail to produce anything, and we’d jump on the formula train.  Easy, peasy, no?

In fact, I was so worried about setting unrealistic expectations that I – yes, Type A, research everything to death me – didn’t do a lick of research into breastfeeding.  I called our insurance just to have an idea what my breast pump benefit was, I registered for a bottle brush and a nursing pillow, and watched a BabyCenter video on breastfeeding holds, but that was literally all I did to prepare.  Just as I’d avoided all pregnancy and parenting conversations for 4.5 years, so too did I spare myself from all things breastfeeding for fear I’d never get to put that knowledge to use.

Trouble was, that lack of preparation led to some pretty uninformed assumptions on my part.  I’d assumed it would be an all or nothing scenario.  I’d either have milk, or I wouldn’t.  My body would work, or it wouldn’t.  I’d be pregnant able to breastfeed, or I wouldn’t.  Black-and-white with no room left for gray.

When the day came for what I thought was the final verdict on breastfeeding, I was anxious.  I asked for a lactation consultant (LC) as soon as we were transferred to the postpartum floor and she quickly arrived despite it being almost midnight.  The first words I said were a simple, “I don’t know if this is going to work.  My breasts didn’t change at all during pregnancy and I have PCOS and Hashimoto’s.”  She was encouraging and said, “Well, let’s try and hand express and see what’s there.”  I was skeptical but started squeezing as instructed and giggled like a silly school girl when a blob of gorgeous yellow colostrum quickly beaded up on my right breast.  “This is going to work!” I thought.  “I’m going to be able to breastfeed!”

For the rest of my stay in the hospital I followed instructions and woke him every three hours to feed.  In the 36 hours between little man’s delivery and my discharge from the hospital I saw 4 different lactation consultants and heard different versions of the same advice multiple times.  He didn’t need much right now.  It was normal for a newborn to be sleepy.  Yes, I’d need to wake him to feed until he regained his birth weight.  No, it was far too early to start thinking about pumping.  Everyone can breastfeed as long as they try hard enough and have enough support along the way.  And, yes, I was doing wonderfully.

On the morning of our discharge out little man had dropped 11% of his birth weight, but we were still cleared to leave.  They reminded me that since he’d been born in the evening and we were being discharged in the morning that a full 48 hours hadn’t passed and that was why he’d lost slightly more than their 10% upon discharge standard.  He was having wet and dirty diapers, latching like a champ (when awake), and I had the support and education I needed to be successful.  I accepted it – happy to get home to my own bed, my own shower, and start my so longed-for life as “mom.”

We were discharged on a Saturday, meaning our first appointment with the pediatrician would fall on a Monday – his fourth day of life.  When Monday rolled around he’d lost an additional 7 ounces.  Our extremely breastfeeding friendly ped felt that our problem was his sleepiness; he just wasn’t awake enough to get an adequate amount down each time.  She sent us off with hugs and words of encouragement and scheduled us another appointment for the following day.  24 hours later – despite 8 hours of active nursing logged in my baby tracking app, no matter the fact that my husband dutifully jabbed his thumb HARD into our little man’s foot every 3 hours like clockwork – he’d gained exactly 0oz.  Nothing.  The ped said not to worry.  As long as he wasn’t losing at this stage they were happy.  Keep at it, drink lots of water, keep waking him however possible, and return in a week.  You’ve got this!

I put my heart and soul into breastfeeding, while, at the same time, I felt like I was falling apart.  The morning of his 2 week appointment Mr. ButIF asked, “Do you think there’s something wrong with your thyroid?  You really don’t seem right and I know I’ve seen this before.”  I knew he was right.  The fatigue I was feeling was more than typical new parent exhaustion.  And, given my med-free birth, I couldn’t think of a single thing that could account for the all-over body numbness I was feeling.  I’d only felt that once before…

But, I knew I’d sacrificed my sleep and sanity for a good cause.  I just knew my baby had grown.  Turns out, however, he’d lost yet another ounce.  My perfectly average, 50th percentile 7lbs 6oz boy at birth was now barely on the breastfeeding growth charts at 6lbs 7oz at 2 weeks old.  Now the ped was getting a little worried.  She recommended the herbs Fenugreek and Blessed Thistle, talked about the drug Domperidone – which she couldn’t prescribe as 1. It’s not available in the US market, and 2. She’s not my doctor – and sent her practice’s LC in to teach me how to use a supplemental nursing system, or SNS.  I was barely holding it together when the LC entered the room with a jug of ready-made formula and the SNS – basically a torture device syringe the lactationally challenged mother fills with formula or expressed breast milk, tucks into her bra, and hooks up to a feeding tube she can either tape to her breast or hold with one of her 4 available hands and sneak into her fussy, hungry (and obviously endlessly compliant) newborn’s mouth when he isn’t looking.  I tried out the SNS in her presence for about 5 minutes – it took the combined power of six hands (mine, hers, and the misters) to get it working – before she sent me off, soaked through my shirt, bra, pants, and even underwear with formula, with a “Good luck, you’ve got this, use the SNS at every feeding!”  I spent the next several days (coincidentally, the first days I was home alone with Baby ButIF since the mister was back to work after his 2 week “vacation”) crying more than my hungry newborn.  I stunk of formula, I hated my body, I was lower than I ever thought I could get with my longed-for miracle in my arms.

When we returned home from that 2 week appointment I immediately called the high-risk OB who’d managed my pregnancy.  Three agenda items:

  1. Please test my thyroid, something is off!
  2. Can I got back on Metformin?  I can feel my PCOS reemerging and it might help me breastfeed.
  3. Will you prescribe Domperidone to help with breastfeeding?

I got the following three answers from the triage nurse.

  1. No, you’ll have a thyroid panel done 6 weeks postpartum, and no sooner.
  2. No, Metformin is not safe while breastfeeding.
  3. Absolutely not.  Take Fenugreek and drink water.

I cheered myself up by crying over my tiny son while I attempted to shove the SNS tube down his throat again.

Our 2 week appointment was on a Thursday, we ordered an infant scale and had it overnighted to us on Saturday, and when our precious baby boy woke up with sunken eyes and even more lethargic than usual on Sunday we weighed him.  He was now 6lbs 4oz.  From a birth weight of 7lbs 6oz.  It was time to stop fooling around with the SNS.  We mixed a giant bottle of formula and my husband fed him while I called and cried my eyes out to the on-call LC at our delivery hospital.  She assured me “true” supply problems were very rare, and that I should keep on with the bottle today and pump religiously every 3 hours for the next 48 hours just to see what we were working with in terms of my supply.  I did exactly as ordered.  Pumping through the night, through the days, pumping with one hand while trying to comfort a newborn just learning what it felt like to be well-fed with the other.  In 48 hours of round the clock pumping I pumped 5 ounces.  Total.

I did two things on Tuesday.

  1. Called my endocrinologist seeking thyroid testing.
  2. Found an amazingly supportive low-supply Facebook support group.

The support group informed me that Fenugreek – that herb that had been recommended by friends and family members, our ped, and, yes, even the high-risk OB practice who had carefully monitored my thyroid throughout my pregnancy – was, in fact, contraindicated in women with thyroid disease.  As in it could make my supply WORSE not better and totally throw off my thyroid in the process.  I immediately stopped it.

The endocrinologist consented to the retest, but wanted the labs drawn at their offices over an hour from my home.  That wasn’t happening with a 2.5 week old that needed to be forced into being fed every 3 hours, with a husband that was back at work full-time, and with a mama that was barely sleeping.  I begged them to let me do it locally.  The cheery nurse on the other end of the phone agreed and said, “OK, I’ll send off the requisition today!”  I said, “Great, here’s my email address.”  She replied, “Oh, no, we can’t email.  I’m sending it in the mail.”  I celebrated that minor victory by crying as I prepared another bottle of formula for my teeny, tiny son.

We first suspected my thyroid was off at 2 weeks postpartum.  I got my bloodwork results at 5 weeks, 1 day postpartum.  Normal range 0.3 to 2.5.  Mine?  0.07.  I forwarded the values to my husband in an email with the subject line, “I’m not fucking crazy!!!”

Things started to turn around then, but remain a challenge.  I’ve since found a fabulous IBCLC (International Board Certified Lactation Consultant) through our county health department who makes weekly home visits to help out (and, oh does she!).  I restarted my Metformin (against doctor’s orders) and saw an immediate increase in my supply.  I ordered Domperidone from a foreign pharmacy and, again, saw a supply increase.  And, most importantly, my breast AND formula-fed baby started staying awake, gaining ounces, and smiling, cooing, and doing all things happy and healthy babies should do.  On any given day he gets around 50% from the breast and 50% from the bottle and that’s a HUGE increase from where we stood a few short weeks ago.  I try to remain realistic with my goals – he’ll never be exclusively breastfed – but I know I’m doing the best that I can, and that’s all I can ask of myself.  I worry about how things may change when I return to work on September 10, but that’s a bridge I’ll have to cross in the coming weeks.  Thankfully that’s a bridge I’ll cross armed with the info and support I most certainly didn’t have in the beginning despite all the LCs and MDs and random strangers on the Internet who told me otherwise.

No, not every woman can breastfeed, but I’m thankful that I had the hard-won strength, determination, and drive that IF gifted me to accompany me on this difficult journey.  Breastfeeding is not black or white, all or none.  I’m finding my way living in the gray.

N’s arrival, pt. 2

So, where did I leave off?  Ah, yea.  3am.  Pants soaked through.

This is really happening…

Actually, I spent a lot of time silently reiterating that.  “This is really happening.”  It didn’t seem real.  After months of Braxton-Hicks contractions that frequently worried my non-stress test nurses but never amounted to anything, I found it hard to believe that early labor was so contraction-free.  We were soon settled into our rooms, wrist bands applied, IV access inserted, and consent forms signed.  Now what?  I decided to sleep, and encouraged the mister to do the same.  I was quickly snoring in my cushy bed, as the mister tossed and turned in his straight-backed chair.  You see, the nurses casually mentioned during our birthing classes that the L&D floor had fewer reclining “dad chairbeds” than they did birthing rooms, but we foolishly assumed that it would be highly unlikely that we’d miss out on said chairbed.  Trouble is, when you come rolling in to the hospital at 3am you’re arriving after the rest of the floor has been tucked in for the night.  No chairs to be had for the mister, and, as a result, barely any sleep as well.  (This will become a recurring theme through the remainder of this tale!  Stay tuned for future posts!)

4am: 2cm dilated, 60% effaced, -3 station

And, so I slept.  Finally at around 7am the contractions started rolling in at a level that, while not all that bad, did make it impossible to sleep anymore.  I do think the poor mister was grateful to have me awake as he had long ago given up on sleeping.  The nursing staff changed over at 7am and we met our new nurse, Liz.  When we first met she said, “Well, my shift is over at 7pm, so you better have this baby before then cause I want to meet him!”  It sounded somewhat optimistic to me at the time (“I’m a first time mom, isn’t this supposed to take FOREVER!?”), but little did I know then that Liz would prove right.  The nurse encouraged me to eat something before labor really started going, so I called up and ordered oatmeal, grape juice, and a piece of turkey sausage!  Certainly one of my weirder breakfasts, but I was unsure about eating too much before labor, but wanted to throw that sausage protein in there for good measure.  This would not be the last time I ridiculously overthought my meals while at the hospital!  In retrospect I wish I had ordered A LOT more.  Note to self: Eat while they’re letting you eat because you don’t know where or when your next meal will come!

10am: 3cm dilated, 60% effaced, -2 station

This is when the decision-making started.  I wasn’t all that surprised that little had changed in 6 hours as I was still comfortably talking through most of my contractions, but it was discouraging none-the-less.  Not the least of which because this meant Liz had to talk to the resident-on-call about beginning augmentation.

As a bit of a refresher: I was hell-bent on a drug-free birth.  (I hate the phrase “natural birth,” don’t you?  It just reeks of smugness like the women who use pain management, who have c-sections, who do what’s best for their babies are somehow “unnatural.”  But, I digress.)  My reasons were many, but I’m finding them hard to articulate now, after-the-fact.  The reasons are there through the anger of my resentment post, but they range from a desire to turn the pain of labor to joy after laboring to deliver 3 prior miscarriages, my wish to experience the same type of labor my (long-dead) mother felt, my fear of drugs increasing the risk of the c-section I’d fought tooth and nail to avoid, my worries that another abdominal surgery would further impair my fertility and/or take more control away from me regarding my reproductive choices, my need to be fully alert and engaged in the process I’d fought so hard to experience, my hard-earned knowledge that my body responds negatively to analgesics, and a healthy dose of stubbornness and commitment to proving how “tough” I was.

So, it was hard not to panic once the discussions of augmentation began.  While I had nothing against pitocin, I worried that allowing a little pitocin would be a slippery slope into pain meds.  At the same time, I had to balance that fear with the knowledge that 1. without pitocin the labor could drag on endlessly and result in my becoming so tired that, again, labor would go differently than I’d hoped, and, 2. that I was working on a hospital-mandated clock because my waters broke at home.  We had 24 hours from when my water broke (11:30pm the prior night) to get the baby out the way I wanted before hospital policy (stemming from a fear of infection) stepped in.

In an odd way, the decision-making was made even harder by the fact that my experiences with my nurse and the resident were completely different from what I’d expected.  Throughout IF and my many other medical (mis)adventures, I’ve gotten serious mileage out of stubbornly pushing my wants/needs/expectations onto less-than-thrilled/less-than-receptive medical professionals.  Given the stories you hear about hospital births in modern America I expected much the same.  I’d have to fight to see my wishes through, I’d have to constantly remind myself to consult the BRAN acronym (What are the Benefits, Risks, Alternatives, and results if we do Nothing?) when having options forced on me.  My actual experience was quite different.  The doctors and nurses were completely hands-off with all decisions, almost to the point of causing me extreme frustration.  If they expressed no preference, then how was I going to battle them?  How would I know if I was winning?  The pitocin decision was just the first of many that went this way.

11am: Started low and slow pitocin drip

Somehow, I expected all hell to break loose once the “nasty” pitocin started.  And, yes, it definitely got worse, but, no, it was still nothing like I expected.  I was giving my longstanding IF-friends-in-the-computer Facebook play-by-plays through it all (have you wondered how I have this all memorized down to the hour?  I don’t – I’m going through old Facebook posts!), and when I mentioned that the nurse was off to get the pitocin one good friendly kindly offered, “Well, I don’t know how you feel about epidurals, but my advice with pitocin is to take the f****** epidural before you think you need it. I was so stuck on having a natural Hypnobabies no-pain-meds birth and… I wish someone had said, hey, pit contractions really are different and it’s OK.”  Not gonna lie, that concerned me.  I was beyond grateful for her advice (and for the fact that before she offered said advice she asked, “Can I offer my unsolicited advice about pitocin?” first… always a good plan!), but my experience was different.  I know I have a high pain tolerance, but I’m also not arrogant enough to think it’s that high.  Namely, I think the reason pitocin and I got along so well was because the nurse agreed to use a teeny-tiny dose and slowly step it up each half hour.  So while the pitocin definitely got things rocking and rolling a little faster, it didn’t lead me to want to break out the drugs immediately.  And when the contractions started picking up in frequency and intensity, and subsequent pelvic checks showed progress, the nurse happily stopped upping the pit and left it at my happy sweet spot.  So far, so good.

That’s not to say that I loved the pitocin or even, in retrospect, think it was entirely necessary.  I grew to have a LOT of angst over the fact that pitocin meant an IV drip and constant contraction and fetal heart rate monitoring.  Those requirements meant I could no longer do my laps around the L&D floor unencumbered, but now was chained to an IV pole.  And, in the beginning, even that wasn’t an option.  Our long string of “good luck” continued.  (I’m not even counting IF, here, but more things like, oh, the fact that the fertility clinic’s entire computer system was down on the day of my embryo transfer so, after years of waiting and knowing what was “normal” for an ET day, we left without seeing or receiving a single picture of any of our blasts…)  Turns out the hospital’s only high quality, portable heart rate/contraction monitor was out of batteries.  And the nurse couldn’t find the charger.  Hilarity ensued over the course of an hour as every L&D nurse scoured the floor looking for the missing battery pack.  It would have been comical if it weren’t for the fact that I was, as a result, left with only about a 5-foot tether between me and the monitor.  I paced that same 5 feet of hospital room continuously for nearly 2 hours before a battery pack was found.  That made me happy for, oh, about 20 minutes until I’d passed the point where leaving the comforts of my room (and bathroom… all those IV fluids!) seemed reasonable.  When pacing went out the window, all I wanted was a birthing ball.  You know, the birthing balls the childbirth class instructors promised us they had in spades?  Yea, turns out they didn’t have any clean balls available either.  So I paced for another hour while I waited for a ball.  The nurse reassured me we were just “lucky” (no chair for hubs, no battery pack, no ball…), but I told her that wasn’t much solace.  I mean, it’s not like I’d be back in next week to see whether the service was better or not.  But, yes, I do think it helped that I maintained my sense of humor through it all.  😉

4pm: 4cm dilated, 90% effaced, -2 station

This is when discouragement started.  Even after all the pep talks, all the knowledge that – especially in first timers – effacement matters more than dilation, all the visualization I’d done while swaying on my long-awaited birthing ball, hearing “4, 90, minus 2” shouted out made my heart sink.  The pain had started in earnest.  After hours of saying, “I thought it’d be worse!” it was now getting worse.  The hubs tried to chat with me as he clocked my contractions on an app on my phone, and in the lull between contractions I repeatedly shouted, “I can’t f-ing talk right now.  Just time the damn things!”

At around 5pm I got off my birthing ball for the last time and instinctually got on my hands and knees on the bed.  Sweat started pouring, tears streaming, groans constant.  I repeatedly had to remind myself to breathe.  I shouted to the mister with the start of a new contraction and sunk into the deepest, rawest pain I’ve ever felt.  Time stopped.

My contraction timing app promised me that in transition contractions could last up to 60 to 90 seconds.  To that I call, “bullshit!”  The contraction that came as I rested on all fours lasted a full 6 minutes without stopping.  By the third minute I was begging for it to end, by the fourth the nurse had entered the room and asked if I needed pain management, by the fifth I’d consented to an epidural and she’d left.  When it subsided I turned over and looked at the mister.  He stroked my brow with a cold cloth, held my hand, and said,

“Are you SURE?”

When the nurse reentered a few minutes later with the epidural supplies I told her I’d changed my mind.  The contraction had passed and, as long as I knew that they’d pass, I’d survive.  It was the fear that derailed me.  The worry that the new pain I was feeling was the pain I’d be feeling constantly until he was in my arms.  As long as I knew I’d have even a few seconds to recover in between, I could manage.  Despite my worries that the nurse would be frustrated with me (what silly things we worry about!), she gladly consented and informed everyone there’d be no need for an epidural.  She went back to checking my monitors without skipping a beat.

Now, many women would probably strangle their husband’s for doing what the mister did, but I’m so grateful he did it.  Many might see his words as questioning my decision, as a failure to support me, but I saw the opposite.  He knew how much a med-free birth mattered to me, he truly believed I could do it, and, as we made the decision to forego the epidural together, he kept saying over and over, “I know you can do this!  I know you’re further than they think you are!  I know how high your pain tolerance is and I wholeheartedly believe that was transition and the worst is behind us!  I know it will be easier from here on out!  I know you can do this!”  And, sure enough, he was right.  It was exactly the support I needed at exactly the moment I needed it.  And, as odd as it may sound, I’m so thankful to IF for his support and my receptiveness to it.  Those moments in that delivery room would have gone quite differently if we hadn’t already had 5 years of supporting one another through the worst under our belts, had we not had the ability to communicate volumes in one look or one hand on the forehead.

At around 5:30pm (the timing gets blurry here!) I told the nurse I REALLY needed to push.  She was beyond skeptical and reminded me I was only 4cm and -2 just over an hour earlier.  She patted my hand, said, “Let’s see if you can have a few more good contractions before I call in the doctor to check you,” and left the room to go back to the nurses station.  A definite hint of panic spread across the mister’s face when he realized he was left all alone in a room with a wife screaming,

“I NEED TO PUSH!”

He held my hand, tried to soothe me, and reassured me it wasn’t time just yet; I squeezed his hand, told him to stop being so patronizing, and bitched about the moron nurse who’d leave a laboring woman alone in a room.  By about 5:45pm I told him, “Screw this, I’m pushing.  I don’t care whether she thinks I’m ‘ready’ or not!”  By 5:50pm I’d pushed through 3 contractions and hubs pressed the panic button and screamed, “Can you please come check her!  She’s pushing!”  Half of me was frustrated my husband had “tattled” on me, the other half was thinking, “About f-ing time you stood up for me!”

The nurse sauntered in, calmly reassuring me that it wasn’t time yet, but she’d gladly call the doctor to come check and give me a progress update.  As she walked by the bed to get to the intercom I think she saw a little more than she was planning on.  The next thing I heard was,

“Get the resident in here NOW!”

Even through the pain I was impressed by the well choreographed dance that played out next.  The bed was broken into a birthing table, more nurses and doctors appeared like magic, each person knew their place, each person filled their role.  Oil was rubbed on the peritoneum, the bassinet was warmed, the spotlight was on, and I couldn’t stop praying that the window that looked out into the neighboring office building was, as I’d hoped, composed of one-way glass.  The resident arrived at 6:05pm and finally gave me formal permission to push.  The on-call attending (amazingly, the same compassionate OB that referred me to the high risk center in the first place!) arrived at 6:20pm.

And our beautiful son was born at 6:25pm on June 12, 2014.

Pushing was a relief after being denied permission to push for so long.  It felt right, it felt natural, it felt like progress.  But the nurse and resident had so convinced me that I had a long road ahead of me, that I couldn’t accept that my pushing was going to be over anytime soon.  As the resident said, “Just a few more and you’re there,” I looked at my husband and said, “She must be kidding, we just started!”  With eyes the size of saucers he looked back at me and said, “No, she’s not.  I see a head.  And LOTS AND LOTS of hair!  Push!”  At that point I realized that he must have been swept up in the grand plan to fool me into being more compliant and motivated for the long road ahead.  I made a note to myself to punish him for his deceit later.  Yet, a few moments later, a wave of relief rushed over me as I felt the head be born.

Still in shock, I reminded myself that that was the worst part and the rest of the body should just easily slip out.  It was over.  I’d done it.  Except, why was there still so much pressure?  Why wasn’t he crying?  Why wasn’t I holding him?  The resident calmly explained that, yes, the head was out, but he’d crossed his arms and was giving himself a big bear hug.  I mean, that would be heart-meltingly cute, right, if it weren’t for the fact that that meant his upper body was now even bigger than his head.  Little stinker!  Despite delivering the head without major trouble, delivering the upper body took the resident a few agonizing minutes longer and resulted in second degree tearing and many, many stitches.  (And probably set the stage for the lovely hemorrhoid I’m still nursing as I type this!)  Nevertheless, he made his quiet appearance into the world.  I only vaguely remember the cord being cut, but I remember each breath, sound, sight, and smell as they placed him on my chest for the first time.  Despite my expectations I didn’t cry, I just held him.  And in that moment I realized he wasn’t crying either…  His eyes were open, and, though he was blue, I knew that was normal.

So why wasn’t he crying?

He was swept away by the nurses and immediately under the care of the NICU staff that they’d called down at some unknown point during the struggle to free him.  My heart stopped for a few moments and it was all I could do not to jump off the table (even as the resident delivered the placenta and began stitching me up – two events I barely remember).  The NICU nurse calmly explained that babies usually spend a little longer than 20 minutes in the birth canal, and that that time is important as it’s when a lot of free fluid is pushed out of the baby’s lungs.  (I knew this fact quite well since it was one of the worries I had should we have had to have a section.)  I couldn’t stop thinking that my quick labor caused it.  The mommy guilt started within 30 seconds of his birth!  After a few (very scary looking) go’s with a long suction tube we started hearing little chirps, then bigger wails, and I knew all was right.  Despite the worry, he wouldn’t need to leave our room, and he never spent any time in the NICU.  He was ours and he was healthy.

He is our dream come true.

NCD ~ June 12, 2014 ~ 6:25pm ~ 7lbs6oz ~ 21in

NCD ~ June 12, 2014 ~ 6:25pm ~ 7lbs6oz ~ 21in

N’s arrival, pt. 1

I’ve sat down to write this post several times.  Writer’s block, sleep deprivation, a continuous string of visitors, and the needs of our little man have intervened.  And, as much as this blog has been my savior over the past year, that’s exactly how it should be.  Life first, blog second.

In many ways I feel like I’m slowly moving back to the land of the living.  A land where acquiring the basic human needs – food, sleep, love – has assumed so much of my time that I haven’t had much left to think about the world I’ve occupied for the past five years.  The one where wants were front and center.  The one where no joy could be found thanks to the constant hole that was felt.  I’ve done both now, and can say confidently that I’d much rather go without sleep than go without hope.  Even through glassy eyes this life lives better.

June 23 was my due date.  June 19 was my scheduled c-section date.  June 16 was my induction date.  June 12 was my baby boy’s self-selected birthday.  What a sense of humor this little man has already.

I should have learned long ago thanks to IF that planning is pointless.  Yet, with a stubborn breech baby who only turned at the 11th hour, with a rare clotting disorder that threatened my placenta, with a history of repeat losses, infertility, and IVF, so much of my pregnancy was planned.  It seemed so unlikely after all the appointments, all the difficult decisions, all the warning signs, that this little guy would catch the mister and I off guard.  But, that’s exactly what he did.

I’ve mentioned several times before that the mister and I are die-hard trivia buffs.  We attend (well, attended!), a weekly Wednesday night game at our local watering hole.  So, there we sat playing away on Wednesday June 11 surrounded by friends, co-workers, and the majority of who’s who in our tiny town.  Looking back now I realize I came within 60 minutes of being a Wednesday night trivia legend.  We left the game a little after 10pm, walked the three blocks home, and settled in for bed and work the next morning.  Just before 11:30pm I felt a substantial trickle.  For one mortifying moment I thought I’d lost control of my bladder, then realized that was unlikely.  I poked the mister, who’d probably only gone to sleep less than ten minutes earlier, and said:

“Um, I think my water just broke?”

One thing that you hear repeatedly – from your birth classes, from pregnancy books, from random strangers – is that labor is not like it is in the movies.  It does not start with a woman walking down the produce aisle at the grocery store and experiencing an unexpected gush of amniotic fluid in front of the peaches.  Except, it seems, when it does.  I was so convinced my labor would not start with my waters breaking, that I spent the next several minutes in disbelief.  I went to the bathroom and looked and smelled and consulted Dr. Google on my phone.  Was I absolutely sure I hadn’t peed myself?  I changed my underwear, grabbed a giant bath towel, and waddled back to bed.  “I guess I’m supposed to call the doctor, right?” I asked the mister.  “I guess,” he answered.  We were both oddly calm.  I called, left a message with the triage nurse, and waited for a call back.  Of course, this is the moment that my cell phone decided it didn’t feel like connecting to the cell tower any longer, so when the on-call resident finally did call back all I could hear was about every fifth or sixth word he uttered through a thick, unidentifiable accent.  I got the gist, though.  Watchful waiting.  If I wasn’t sure sure it was my waters, then there was no reason to panic.  I should only plan on coming in if it happened again.  Get some sleep.

And, that’s what I did.  On my giant bath towel wearing a super pad.  Until 12:45am when the flood gates opened.  I was on my hands and knees in bed pouring forth like Niagara Falls when I shook the mister again.

“Er, yea, no doubt.  <Nervous laughter.>  My water is totally broken.”

Through this all the awkward calm continued.  I was having no contractions, and knew full well that there were no perks to getting to the hospital early.  Just a lot more sitting around in an uncomfortable environment.  I got up, changed my pad/underwear for what felt like the hundredth time, took a shower, did a load of laundry (all those soaked bath towels and undergarments weren’t going to wash themselves), ate a granola bar, kept the mister company as he made himself coffee and a breakfast sandwich (half as fuel for the night ahead, half to soak up what remained of that double scotch he’d had at trivia!), grabbed the car seat, fed the cats, and prepared to leave for the hospital.  As I walked around the house with another bath towel between my legs I kept thinking:

“Am I seriously about to have a baby?”

After moving to this rural village 2 years ago I sought out excellent doctors no matter the distances I had to travel.  That is, for all but obstetrical care.  We moved here fresh from my second miscarriage, and I still had hope that some day my body would get it right.  Some day we’d be doing that midnight drive to labor & delivery.  Some day I’d be happy I’d picked the closest OB I could find.  When that closest OB botched my third miscarriage, I succumbed to the lure of the talented professionals in the nearest city, and prepared myself for an hour drive in labor.  As news of our pregnancy spread, friends and family alike looked puzzled as I explained that I’d be delivering fairly far from home, and I came to embrace the, “Well, I had no choice in hospital,” line once that wonderful city OB transferred me to an equally wonderful high-risk practice that only delivered at the wonderful hospital an hour away.  After 9 months of hearing and internalizing, “How are you going to manage that drive in labor?” it was wonderful to embrace my 10% status as me and my soggy bottoms made the hour drive covered in amniotic fluid, but totally without contractions.

When we did our hospital tour a couple months earlier, a highlight was learning of the valet service that would remove the “What do we do with our car?” confusion from what we were sure would be a confusing and tense time.  Those giving the tour, however, failed the inform us that said valet service comes with limited hours of operation.  As we rolled up to the hospital at 2:45am we were greeted by a sign noting that valet parking begins at 6am.  Sure, I could have gotten out and either waited for the hubs in the lobby or informed the desk attendant that he’d be by behind me, but I didn’t really feel like having to stand about flooding out public spaces without my husband by my side to share in the mortification.  So, I did what came naturally.  I rode with my husband to the nearest parking garage, helped him find a spot on the far end of the 3rd floor, delicately extricated myself from the passenger seat of our (NEW!) car that I had carefully wrapped in plastic and covered in bath towels, waddled down three flights of concrete steps (“No, I’m fine, I don’t feel like using the elevator!”), and shuffled the few blocks uphill toward the hospital in the cool 3am air.

There was one other thing the nurses had gotten wrong during our birthing class/hospital tour.  As we wandered around the labor and delivery floor, they let us – especially the “first timers” – know that we shouldn’t take it personally when the labor and delivery nurses treated our arrival to the 8th floor with a fair bit of skepticism.  “You may feel excited, you may be screaming inside, ‘THIS IS IT!’, but your labor and delivery nurses will still almost certainly send you to triage where you’ll wait to be evaluated before being given a room, or told to go home.  Don’t get discouraged, this is all a normal part of the process!”  So, while the lack of a valet caught me off guard, I wasn’t going to let anything else catch me off guard.  I mean, I was so prepared for this wait that I’d actually, you know, done two loads of laundry before driving the hour to the hospital!  But, sure enough, when the nurses of floor eight saw the very pregnant lady waddle in sporting jeans that looked like they’d just gone for a swim in a backyard swimming pool, their response was a jovial,

“Well, we don’t need to triage you!  You’re in the right spot!  Let’s get you a room!”

The large digital clock above the nurses station glowed red with “3:00:00” (why does that stick out in my mind?) as we were ushered off to room 8020 for the foreseeable future.  And, with that, it’s time to feed the little man whose kitty binky just isn’t cutting it anymore!  Hopefully it doesn’t take another month to write the final installments of this journey!  Until next time…

Resentment Addendum

If only all problems could be solved by whining about them on a blog.  Wouldn’t the world be a much lovelier place?  I mean, sure, the blogosphere would be a little gloomier for it, but me and my Eeyore self wouldn’t really mind.  Who wants to read about others’ happiness anyways?

Well, shit.  Yea.  If you don’t want to read happy you might want to stop here…

Less than 24 hours after my last post the mister and I piled into the car for another sleepy, early morning trek to the perinatal center.  (Well, another for me, a first for him.  Thanks to the number of appointments I have, the distance they are from our house, and the state of medical/family leave in this grand country of ours the mister has never been able to come with me to the MFM.  Yesterday he said “screw it” and took some of the precious, precious vacation time he’d been saving for post-baby to come along to my appointment.)

The drive to the perinatal center takes about the same amount of time as the drive to the RE did (an hour, give or take), of which the initial half hour is the exact same drive.  I know the drive well.  Every bump, turn, hamlet (yes, in New York we have hamlets), and village.  I like the drive to the MFM better, though, because the last 10 minutes is interstate highway, as opposed to the sleepy country roads that comprise the rest of the drive there and the entire drive to the RE.  There’s something about flying down the highway, if even for a few exits, that makes you feel like you’re making better progress than you would be were you on a country road.  For that last ten minutes I open the windows, inhale the big-rig fumes, and celebrate being almost there.

Yesterday, amidst said celebration, with the city skyline just popping into view, I let out a simple, “Woah!”  The mister looked at me puzzled and I explained, “Holy crap, now THAT was one heck of a kick!  It felt like my abdomen was exploding from all directions at once!”  We chuckled, I took a few deep breaths, and, one hand still planted firmly on the wheel, I felt around the upper right side of my abdomen where the little man’s been parking his head as of late.  A quick inspection confirmed a round, hard mass still lodged in it’s usual location.  As I thanked him for reminding me he’s still there, I accepted the fact that, of course, he was still breech.  The head was still where it always was.  Tucked under my ribs, using the placenta as a pillow.

Less than 30 minutes later – post-weigh-in, post-BP, post-pee-in-cup – the NST room nurse did my usual fluid check ultrasound.  She put the wand to his “head,” but there was no head – just a nice, plump bottom.  We looked at each other in disbelief.  She zipped the transducer down, down, down, and, sure enough, there he was.  Head.  Down.  I looked at the mister and said in my crankiest voice, “So, are you telling me, all I had to do this entire time was bring you along and he’d flip?”  We laughed, and a smile went across my face that I’ve been unable to remove ever since.

The c-section remains scheduled so that I won’t lose my surgical slot if he flips back around, but other than that, we’re cleared for a vaginal delivery with induction sometime in the 39th week.  It’s crazy how much one little flip has impacted my psyche.  I’m not going to get arrogant and assume that things will go remotely as planned.  The specter of a c-section still looms, especially if we induce.  And, he could very well decide to flip back over next time I’m barreling down the highway.  But, just having the knowledge that, in this moment, I get to try to have a chance at labor.  That’s huge.

And, to all of you who wrote in response to my last post – thank you from the bottom of my heart.  I can’t tell you how comforting all of your words were, especially coming on the heels of so much stress and worry about how my reaction to the c-section news was something too taboo to share in a space like this.  I’m constantly amazed by the strength and compassion you each exhibit.  And, damn, there I go making this a happy blog post!  <sniff sniff> Thanks everyone!

Resentment

Here’s the biggest thing I wasn’t prepared for when it comes to pregnancy after infertility.  Sometimes, while pregnant, you get depressed.  You worry, you cry, you panic.  That I was prepared for.  But the self-loathing and shame that can result from those worries and tears and panics?  Not so much.  I’m not going to lie.  I’m a total mess right now.  And, I think it’s been made worse by the fact that I haven’t felt like I could write it here.  I haven’t felt I could express it anywhere.  Not to friends, not to my husband, not to my therapist.  I hate myself and who I am right now, and not the least of which because I know I should be better, I should cope better, I should be grateful.

This little man’s been breech at every. single. visit. since the NT scan at 13-some weeks.  I was proud of myself for not worrying too much about it, because I knew it wasn’t a cause for concern until some far off, distant “later.”  It appears later is here.  Or, so it would seem from the simple one-page letter I unexpectedly got in the mail on Saturday telling me the date and time of my c-section.  The date and time of my son’s birth.

Since “the letter” I’ve been a disaster.  I cried for most of the rest of Saturday, managing to haul myself out for a few hours that night for a going away party for one of my closest friends here who will be moving to the other side of the country in a few short days.  Sunday I struggled to hold it together, but was still mostly in a daze.  Monday found me losing all composure throughout my morning ultrasound, non-stress test, and consult, and going through the motions of the rest of my workday, only to come home and snap.  I stayed awake long enough to do my 7:20pm lovenox injection, before going to sleep without dinner, without stopping the tears, without emerging from the darkness that had become my new mode of being.  I do remember my husband begging me to reassure him that I wasn’t thinking of “doing anything stupid” before I stumbled up to bed.  I remember waking 12 hours later, remembering the look in his eyes as he asked it, and starting to cry again.

I feel trapped between two worlds right now.  The “what should be’s” and the “what is,” the “I know better’s” and the “I’m tired of knowing better’s,” the “gratefulness” and the “jealousy.”

When I try to be rational, I eek out the following:

  • Holy shit I’m pregnant.  Really, REALLY pregnant.  Like, I may very well get to meet this child pregnant.
  • There is a nursery.  In our house.
  • You’ve got bigger things to worry about.  Like him surviving you coming off your meds.  Like him surviving.  Period.
  • The method of his delivery doesn’t matter, just that he gets here safely.
  • Seriously, read the above, you know better you fucking twat.

But, 99% of the time my thoughts are more of the variety of:

  • I’m tired of being understanding.  I’m tired of accepting what life throw’s at me.
  • I’m done with being the minority.  The 1.5% of births from IVF in the country.  The 2-4% of the general population with antiphospholipid syndrome.  The 1-3% of women who have scheduled C-sections due to a breech presentation.  The list goes on.  I’m a walking, talking ball of “This is SO UNFAIR!” right now.
  • I’m over surgery.  The C-section will be my 6th in 4 years.  Everyone assumes I’m upset because I’m “scared” of surgery.  No, I know surgery intimately by this point.  There is no fear there.  Just a lot of anger.  And, a lot of knowledge of what recovery will look like and physically and mentally feel like (especially given how much my body detests analgesics).
  • I’m sad I’ll never get to experience what my mom did to bring me into this world.  The only labor pains I’ll ever know are those that accompanied my three miscarriages.  I’ll never have the chance to turn that pain to a positive in my mind.  I needed that chance, I’ve been longing for that chance.
  • I feel robbed.  It’s not so much that I feel vaginal delivery is “normal,” but it’s certainly less invasive.  My child was conceived in a petri dish, this pregnancy has been sustained by tons and tons of drugs, procedures, and doctor’s visits, and now the birth will be more of the same.  It will be a timed transaction – place, date, and time preset by the convenience of my medical providers.  It will be another procedure written in my calendar.
  • I’m sick of an entirely new set of reminders from the fertile masses that I’m different.  Each well-meaning moron that tells me, “Labor isn’t what it’s cracked up to be,” or “you can always VBAC with your next one,” or “it won’t matter once he’s in your arms,” leads me one step closer to homicide.  I knew I would kick labor’s ass, and I’ve been longing for the opportunity to for 5 years.  I have the pain tolerance of an ox, and I’m ready to have it come into play when something positive can come from it.  And, speaking of “the next child” just reminds me that may likely never happen.
  • While I’m not scared of surgery, I am scared of the possible health implications.  Since I continually win the medical complication lottery (seriously, who gets diagnosed with 6 different diseases/conditions all before they’re 30?), I find myself certain that this C will result in endometriosis adhesions growing out of my uterus.  Yes, it happens.  Or that major abdominal surgery will set off my clotting disorder.  Or my yet-to-be-determined spondyloarthritic disease.  Or that, when you’re as infertile as I am, more scarring in the uterine cavity is never a good thing.  Especially when the combo of endometriosis and a clotting issue mean you’re in for a lot more laparoscopies down the road.
  • I’m frustrated that this birth feels like just another in a long line of confrontations with unhelpful, risk-averse, blanket statement doctors.  I haven’t seen an MD since February, and my case hasn’t been looked at in all that time.  (And, clearly, a lot has changed since then.)  Yet, the NPs and midwives continue this game of telephone.  Gathering my questions, presenting them to “some doctor” (one who may or may not have ever met me), and then coming back in the room and poorly communicating their answers.  For 6 months I’ve been told it would be dangerous for me to remain pregnant past 39 weeks, but now that they must schedule a c-section it’s been scheduled for nearly 40 weeks.  The NPs helpful response?  “Well, we’d sure like to do it sooner, but we don’t have any surgical availability.”  After one doctor told me in February that my lovenox was the only thing sustaining this pregnancy, now they’re taking me off of it without a second thought on Monday.  No discussions, no explanations, just a simple, “Your chart says for you to stop at 36 weeks.”  And, to my question of whether or not we could try an external cephalic version to flip him?  The friendly nurse replies, “Absolutely not.  Not with your history!” Oddly, that’s not remotely OK, but delaying delivery and taking me off my meds is totally fine.  This is not how I pictured my end of pregnancy care.
  • And, I’m angry that this is the end of the line.  I want to meet him more than anything, but I’m not ready to be once again un-pregnant.  Aside from the fact that I have physically felt the best I have felt in 10 years during this pregnancy, I’m also not ready to let go of him.  Especially since I’ve wasted so much time lately hating each kick that reminds me he is breech.  Especially since the medical system has been the only one to weigh in on when he arrives.

Clearly, one list is much longer than the other, but that doesn’t mean that the first list isn’t on my mind.  It is.  Constantly.  And, it’s why I’m such a mess.  Where do I get off feeling like I have any right to be upset over a c-section?  I know better.  I mean, I know better women than I who just lost wanted pregnancies, who failed yet another cycle, who’ve moved on to a life sans children, who’ve suffered more heartache and pain than anyone should ever endure.  Yet these past few days have sunk me lower than I’ve been since the death of my mother.

I have no answers.  This is hard.  And overwhelming.  And terrifying.  The risks are so high, and the territory so uncharted.  For me, infertility always had an element of misery.  Misery’s not all bad.  It unites the community, it can make the highs feel higher, it can be powerful and reaffirming to let it wash over you.  But, I’m so frightened to be spending these last few weeks of pregnancy in misery.  What does it say about me?  What does it mean about my ability to successfully parent?  What does it foretell about the future if I can’t ever get past these few final road bumps?  I’ve often bought in to the normative language that the ALI and PAIL communities frequently use – the phrases “finding a resolution to infertility” and “living after resolution to infertility.”  I doubt the accuracy of those phrases now.  I doubt that resolution will ever be possible.

On the verge…

… of parenthood?  Of breakdown?  Of both?

I keep trying to figure out why it is that I’m having such a hard time writing about my pregnancy here.  The posts flowed so much easier when I was under the influence of Gonal-F and endlessly waiting for the next laparoscopy, the next cycle, the next miscarriage.  At first I thought it was the inevitable IF guilt.  That deep-seated uneasiness with the fact that I was “moving along” while others were left to do the same things over and over again in the hopes of a different outcome.  Or left to rightfully rail against the very concept of hope itself.  And, yes, that guilt did factor in; but, I think, less than I initially thought.  Ultimately, the primary issue is I don’t know how to live and write equally in the lands of fear and joy – a skill that pregnancy after IF requires.  I’ve known what I felt, what I’ve wanted to say, what I’ve secreted away in my mind these past many months, but I just don’t know how to put it to paper.  Or even if I can put it to paper.  I’ve returned to the realm of the bogeyman, where it feels as if what I think, what I say, what I write will automatically land me in the bad graces of those unseen beings who decide my fate.  The simple act of sporting this belly feels like a daily act of hubris, for which I’m constantly sure I’m in for a rude awakening.

In trying to decide why this all feels so, I’m struck by how similar the IF and PG-after-IF emotions I’m feeling are.  Top of the list at the moment is the seesaw.  With twice weekly non-stress tests at the perinatal center I feel like I’m, once again, living from appointment to appointment.  Every three to four days my psyche is formed by the lines on the NST ribbon and the words of that day’s nurse practitioner or midwife.  One day I’m told how grand I’m doing (“minimal weight gain, stellar 1-hour glucose screen, you’re a rockstar!”), and the next I’m discussing the possibility of a looming c-section (“he’s still breech and, since we’re taking you off of the Lovenox at 36 weeks anyway, we might as well just do a c around that time!”).  A week ago one of my favorite midwifes poo-pooed the early c idea (“you’re still so early, and there are things we can try!”), only to have another preferred practitioner inform me this Monday that I had suddenly developed polyhdramnios (too much amniotic fluid) and we, “desperately need to get to the bottom of this!”  In a few short hours I trek an hour north again for a full afternoon of ultrasounds, NSTs, blood tests, and consults.

I’m exhausted.  Even at its best spending 5-6 hours each week in the car on the way to and from appointments is tiring.  Another 3-4 hours each week in waiting rooms and on exam tables doesn’t help.  Adding in the need to keep up with my full-time job during one of the busiest times of our semester brings me close to the edge.  When you factor in the frequent Braxton Hicks chipping away at my physical and mental stability I’m pretty much done for.

But all those stressors are the easy ones.  The ones that aren’t that hard to write.  The ones I start my therapy sessions with.  The ones that get me pity from most ffergiles and justifiable dagger-eyes from those still waiting to parent or finding peace in the decision not to.

Then there’s the much louder chorus of other concerns for which I have a private concert.  Most days I wake up waiting for the first kick or rumble.  As I pray for it to come, I run through what life post-still birth would look like.  I watch it play out from outside my body; me, sitting in silent grief and despair in our darkened bedroom, the mister bringing me food and handling the obligations of daily life as he cries alone in the shower.  Our families not knowing what to say and, likely, taking it even harder than we do.  After all, we’ve walked these halls before.  The failed cycles, the dashed dreams, the early losses go, if not unfelt by those in our inner circles, at least a lot less felt than for those of us with front row seats.  Soon, these morbid morning thoughts are replaced with anger, nearly all of it directed solely at myself.  What have I been doing for the past five years if not running and screaming from medical office to office demanding something was wrong?  Insisting I was sick?  How could I relentlessly pursue diagnoses in one breath, while doing everything in my power to become pregnant in the other?  I often feel shamefully selfish, and that’s really hard to admit.  For 4.5 years I’ve allowed the words “brave,” “determined,” and “driven” to shelter, protect, and uplift me.  Now I often feel like a fraud and a failure.  If we lose him, I am to blame.  My body did it.  And, most of all, I should have known better.

But, then he kicks.  Or he hiccups.  I catch a glance at the nursery.  Or I sit down to work on my shower thank you’s.  The mister gets misty in the eyes looking through the story books his parents gave us.  Or I find myself subconsciously rubbing my belly.  And it all melts away.  I’m quite easily the happiest I have ever been in my life.  I love my husband beyond words as he talks to our son and dreams of the future.  I miss my mom desperately, but I’ve never felt as connected to her as I do in these on-the-verge-of-mothering moments.  The contractions and kick counting are often overwhelming, but they always remind me that I’m living a moment in time I truly never thought I’d see.  For all that I’ve dreaded showers over the past five years, my own were beautiful and surprisingly cathartic.  And, not the least of all, I feel the healthiest I have in my adult life (no “unknown rheumatalogical condition” back pain or rashes, no endo constipation or crippling cramping, no Hashi’s fatigue or brain fog, no PCOS weight gain or hunger pangs).  Life is really, truly, deeply wonderful.

And, at the same time, life keeps on moving and fear keeps on sneaking in.  In the past week I registered for daycare, set up an appointment with our desired pediatrician, started really putting the nursery together, and continued planning for my maternity leave from work.  Yet, each time I cross one of these items off my to-do list I can’t help but feel like I’m adding them to a “what we’re going to have to undo” list.  I feel like I’m laughing at fate by planning for a child that may or may not arrive safely.  I can’t help but see myself un-registering, appointment cancelling, un-prepping the nursery, spending the summer in my desk chair.

The seesaw keeps rocking at the peak of a mighty mountain and I know I’m destined to fall off.  I’m just not sure which tranquil valley or cursed forest I’m perched above…

Resolve to know more about the lasting scars of infertility

* Note: Since new readers may stumble on this post via my submission in the Bloggers Unite challenge, a word of warning.  This post will discuss a current pregnancy, past pregnancy losses, and plans to parent after infertility.  Please tread lightly if any of these topics are triggers.*

 

It’s National Infertility Awareness Week (NIAW) yet again.  It’s hard not to let a milestone like that make you pause and reflect.  This will be my fifth NIAW as a mother-in-waiting; this will also (hopefully) be my last NIAW as a mother-in-waiting.  Today marks 31 weeks 1 day gestation of the IVF miracle kicking away in my belly.  (Somehow “miracle” doesn’t seem the right word for something that a healthy mixture of science and dumb luck created, sustained, and guarded for the past 7 months, but our language is full of gaps when it comes to the often taboo topic of infertility.)

When we started naively trying for our first child five years ago, I knew nothing of NIAW.  I knew hope and optimism.  I knew the emotional tears of joy and connection that dripped down my cheeks after the Mister and I really “tried” for the first time.  I knew the worries about having enough money, where to put the nursery, and wondering if we were really ready.  I knew absolutely nothing.  Five years, three miscarriages, three surgeries, thousands of pills and injections and doctor’s visits later I struggle to remember who that woman was.  I’m tempted to despise her naivete, to squirm at the thought of her cluelessness, to shout at her for all the times she’d asked casual acquaintances, “So when will you have kids?”, to slap her for telling her inlaws over lunch one early spring day that she wouldn’t be having caffeinated tea because, well, they were “trying.”  Then the frustration and anger I feel fade and are replaced with deep sadness.  I will never know that woman again.  She’s gone for good.

Four years ago I still had never heard of NIAW, but I was starting to get acquainted with “infertility.”  Even before a year of trying (the standard period required for an infertility diagnosis at my then-age of 27), I knew I was infertile.  In 8 months off of birth control I’d only had three periods.  I’d already become disillusioned at the prospect of buying and wasting home pregnancy tests, I reflected back to the “normal youthful” irregularity in my cycles which had landed me on birth control at 18 to begin with, and I was increasingly anxious for answers.  I began to dip my toes into the world of online fertility charting and chat rooms and learned how it felt to have my heart break each time a “friend in the computer” crossed to the other side – the pregnant side – without me.  In the beginning I allowed my doctors to convince me that the pressure I was feeling explained my mood swings and depression.  I was told it was “typical” for cycles to fluctuate after birth control, for conception to take up to a year, for a little bit of anxiety to set in when it didn’t work like it did in the movies.  For months I lived two lives – the driven professional woman who worked full time and attended graduate school in the evenings and on weekends; and the scared little girl who felt like her body and soul were breaking.  Worst of all was the knowledge that the only things wrong with me were impatience, a low pain tolerance, obesity, and a little “run of the mill” depression.  Then one morning in February I woke up in a panic.  I didn’t know who my husband was.  When he handed me the phone to call out of work, I didn’t know how to use it.  He got me in with our doctor (yet again) that same day.  She (again) repeated that I had a busy, stressful life and likely just needed a hobby, to get more exercise, and to relax.  But, she also agreed to run blood work.  The next day, February 8, 2011, marked the beginning of  the next phase of my infertility.  It was the day I was taken seriously, the day I started to get answers, the day we learned my thyroid had basically given up.  Ultimately, it was the first day I knew I was ill.  It was liberating and terrifying in equal measure, but I celebrated it as the beginning of the end of my fertility troubles.  A pill a day, a few blood tests, and I was assured we’d be pregnant in no time.  The diagnosis of PCOS a few months later came with the same good news: two pills a day, diet management, and I’d be pregnant in no time.  I embraced each new diagnosis as a sign that we were getting closer to our goal.  Looking back I still feel much the same, but I wish I could take myself aside and tell myself not to celebrate prematurely.  The doctor’s visits would continue, the diagnoses would continue, the familiarity with the American medical system and insurance regulations would bloom into another full-time job.  The journey was still at its starting point.  I needed to pace myself for the diagnoses and surgeries to come.

NIAW 2012 was the first I celebrated.  On Wednesday night we attended a fundraising dinner hosted on behalf of NIAW by one of the members of my new RESOLVE Peer-Led Support Group.  Yes, I’d formed my state’s first (and still only) support group.  I’d done it as a way to pass the time and to dull the ache of my first miscarriage a few months earlier.  The miscarriage that may have been/may not have been an ectopic pregnancy.  The one that was treated with chemotherapy that sidelined us from trying again for 3 months.  The one that was mismanaged by an OB/GYN that had no time or patience for me.  The one that inspired us to finally seek out a reproductive endocrinologist no matter the financial cost.  NIAW found me at the perfect time.  Our souls had been crushed, the tears were free-flowing, the sense of isolation and separation from the “normal” world was smothering me.  NIAW 2012 bore the message “Don’t Ignore Infertility!” and I listened.  I raised my voice in our support group meetings, I embraced my core group of “fertility friends in the computer,” I shared our story on Facebook to highlight the dangers of personhood legislation, I signed us up for the 2012 Walk of Hope.  Each bold and public move was underscored and fueled by another private setback or heartache.  2012 brought my second miscarriage, the laparoscopic surgery that diagnosed my endometriosis, several failed cycles with our first reproductive endocrinologist, and a job offer from another state that removed us from the support networks we’d built for ourselves just as it gave us the gift of working in a state with a (weak) infertility insurance mandate.  I learned the hard way that infertility can and does impact so many life choices.  Where to live and work, how to form deeper bonds with old friends and quick bonds with new friends through shared struggles, how to answer, “So, do you have kids?”  And, at the time, I was proud of the strength I’d found through my growing engagement with the infertility community and becoming an infertility advocate.  I still am today, but its become bittersweet.

Last year I started this blog, I submitted a post to the Bloggers Unite challenge, and I was humbled to be selected a finalist for last year’s Hope Award.  My public self was riding high on the cause of infertility, as my private self mourned the loss of our third pregnancy.  We’d seen the heartbeat only to see it cease.  We’d driven 8 hours in one day only to be told my our last chance specialist that only time would tell what would become of the pregnancy.  We’d traveled to maternity triage for an emergency D&C only to be told it couldn’t be performed on a Saturday and be sent home with sterile collection jars for the products of conception.  My “Join the Movement” post was largely, if not joyful, at least driven.  Yet, I wrote it as the Mister and I talked in quiet rooms about when “enough was enough,” when we’d move to a life without the prospect of children.  I was struggling to put my voice to it then, and frequently still struggle with it now, but last year’s post showed me even more clearly the duality of a life lived under the specter of infertility.  The pride, joy, empowerment, and, yes, even hope kept me going.  It provided me with a sense of self and purpose beyond my own struggles.  It made the injections and visits and surgeries bearable.  But, in time, that same empowerment, that same respect for my own needs and emotions, started to take away from the drive to continue.  It allowed me to reframe our failure to conceive and sustain a pregnancy as something other than failure.  It gave me the strength to set limits.  We’d complete an IVF package with all the pharmacological bells and whistles our far away specialist had recommended and when those cycles were done we’d be done.  The baby boy who’s kicking me resulted from IVF.  The “unnecessary extra meds” from the specialist – steroids and blood thinners – sustained the pregnancy.  The attentive OB/GYN I picked out of the yellow pages acknowledged my fears and ran the tests that got me my latest diagnosis – antiphospholipid syndrome.  The high risk pregnancy practice that OB/GYN referred me to has kept him baking even as my body has endeavored to resist their efforts.  All of the above led me to want to label this year’s post something along the lines of “Resolve to know more about how much dumb luck is involved in this process.”  But that ultimately felt off base with the emotions I’m feeling right now as I sit on the precipice of (hopefully) parenting after infertility.  And setting that parenthetical “hopefully” to virtual paper finally gave me my prompt, finally guided all the words you’ve read to this point.

This year I resolve to know more about the lasting scars of infertility.  The physical, emotional, and financial scars are ever-present.  They’re the nervous tick that keeps me from writing with certainty that I’ll definitely be parenting after infertility by June.  They’re the sadness I feel at having lost the connection to the woman I was during NIAW’s past.  They’re the frustration I endured when reassuring our accountant that, yes, I had indeed traveled over 4,000 miles for medical treatment in the past tax year.  And, yes, they’re even the raised red lines that traverse my pregnant belly marking incisions past, and reminding me of the incisions I’ll face in the future as I continue to navigate life with both endometriosis and a potential clotting disorder.

I never really thought that a lasting pregnancy would “cure” my infertility, but I also wasn’t quite prepared for how deep the scars would be and how sore they’d remain.  I miss that naive girl, I miss the (illusion) of health, and I miss the ability to make life decisions without questioning how they’ll impact me as an infertile woman.  For five years I was certain I knew my ultimate goal.  Yes, it changed a little – from pregnancy, to lasting pregnancy, to some sort of final and personally acceptable resolution to our infertility – but I always knew what we were reaching for.  I always had an idea where the finish line was located, even if I was having trouble getting there.  Today I don’t have that certainty.  Today it’s easier to reflect on where I’ve been, than to contemplate where I’m going, because it’s the past that’s given me these scars, and the past that will dictate how they shape my future.

Maybe I’m a bit strange, but when I woke up from my first laparoscopic surgery in 2012 I was proud of the scars that I bore.  They indelibly marked this struggle in a way nothing before had.  They added a physicality to this battle that I’d carry around with me for the rest of my life.  I’m finding now that those visible scars are just the tip of the iceberg.  Just as there’s no balm to vanish these incisions, there’s no salve to erase the many scars of infertility.  I continue to wear them all with honor.

 

To learn more about infertility, NIAW, and RESOLVE: The National Infertility Association, please follow the links below: