Wednesday, January 21, 2009

Where to begin?

(Warning: The content of this post may be a bit too personal/graphic for some readers. I give my friends with low TMI tolerance permission to just skim this post.)

I have started this blog post a dozen times now. Each time I think I know what I want to say and that I am strong enough to actually say it... and then I hit the wall. I lose it, and I have to stop. I am hoping that this time I will be able to get out everything that I need to say, and maybe get some closure.

For those of you who don't know yet I guess I should start at the beginning, or more appropriately the end... last time.

When we lost our Emily Hope in September, I can honestly say that I had never experienced emotional pain of that degree before. I had lost friends and family members, but to lose a child... even one you never held... it is something no one should ever have to experience. I felt lost and trapped in my grief for what felt like forever. The act of naming our lost little one seemed to be a hugely cathartic process, and once we knew who she was I felt like I began to heal.

I truly believe that I was well on the road to feeling like my old self again. I was back at work, and was looking forward to the busy Christmas retail season. My Beloved and I went to a very long awaited concert (for me anyway... I know that New Kids on the Block aren't his thing, but he showed the dignity that only the husband of a boy band freak can show, and laughed at me the whole time), and decorated our new condo for Christmas.

On December 6th, after having a mysterious case of hives for a couple of weeks and feeling even more tired than usual for the maddest time of year, I caved and peed on a stick. The second pink line showed up and I was thrilled. I knew that it was likely that we would be pregnant again soon and that the odds were in our favor that this little bean would stick. The percentage of first pregnancies that end in miscarriage is high, almost 25%, but for second pregnancies things improve greatly.

I found myself thinking things like, 'This will be my last Christmas in retail for a while!' and 'Next year we will have a little one to plan Santa Claus stuff for'. We were excited, and decided on what we thought was a very clever way to tell our parents our news. We bought silver elephant-shaped frames and I took a picture of the positive pregnancy test.

About a week and a half before Christmas, I had a couple of truly panicky days. I was terrified. Last time I didn't know for a full month that the baby had stopped developing. How could I trust my body? How could I know for sure? What if the unthinkable happened again? Somehow, through prayer and the encouragement of my Beloved, I was able to snap out of it and got very excited about our doctor's appointment on Christmas Eve morning.

We went together, and the first thing that tipped me off was when the nurse asked if I had had a positive home pregnancy test yet. This was three and a half weeks after I had gotten my first positive at home. I told her I had had five (I'm nothing if not thorough). She just nodded, weighed me and told us to wait for our doctor.

The doc came into the room, and immediately I was worried. He opened my file and told us that my HCG (that's the pregnancy hormone, for those of you who aren't obsessed with procreation) levels were not as high as he would like. The were rising, but very slowly. That seed of doubt took root in my heart, but I tried to brush it away. Maybe I ovulated later than I thought or the bean implanted later... both of which could affect HCG levels. When we left the doctor's office I was in posession of another requisition for two more blood tests and a date for an early ultrasound to confirm my dates.

We celebrated Christmas... our families each having their own reactions to our news. My in-laws were over the moon excited. My mother-in-law cried and thanked us for the only gift she really wanted. My mom was a little more reserved, but I know it was just her way of trying not to get too excited after last time.

After Christmas, I began the countdown to the ultrasound. I was nauseous and tired. Parts of my body ached like no woman's body should ache. I had all the typical early pregnancy symptoms. On January 6th, after drinking a ridiculous amount of water, we went to the clinic to see the first glimpse of our new little blessing.

I was excited and hopeful. But that seed of doubt was still there.

I was nervous as the technician started the scan. I was uncomfortable, it felt as though I was going to wet myself any second. And I could see the screen. An empty screen.

That feeling... laying there, praying that something would show up, that we would seel that little bean-shaped miracle... the feeling of hope crashing down to the floor surrounded me. After another few minutes of agony, both physical and emotional, the tech stopped the scan and told me I could go to the bathroom. The doctor would see us in a few minutes.

The doctor, the on-call doc at the fertility clinic where we had the scan, came into the room and bluntly told us that there was no baby. Either my dates were wrong or I would miscarry. I explained that I track my cycles and that I had a positive home test in early December. He then said that I could wait until I started to bleed or I could have the receptionist book an appointment for the procedure to 'take care of it'.

We left the clinic heartbroken. I called in sick to work, and we made the calls to our parents to tell them that it happened again. I spent the rest of the day on the couch, bouncing back and forth between sobs and numbness.

We had an appointment already planned with our family doctor for the next day, and by the time we got there I was resigned to another D&C procedure. When our doc came into the room this time, he was surprised at the news we gave him about the ultrasound because my HCG levels had risen significantly in the last two weeks. He was adamant that we 'treat this situation conservatively'. I was to take it easy, try not to stress (yeah right!) and wait another two weeks. He was very hopeful that the baby was just hiding, or we were a little off on the dates. We left that appointment armed with yet more requisitions for bloodwork and another ultrasound.

And thus began the two weeks from hell...

How do you hope and not hope at the same time? How do you allow yourself to feel anything at all? Do I grieve? Do I let myself be swayed by the continued morning sickness and exhaustion? How do we tell the family and friends who are already grieving with us that there may yet be hope?

I don't know how, but I made it through. My Beloved was wonderful through this time. Our Pastor was checking in every couple of days to see how I was doing. My sister texted daily to check in and distract me. Work was a challenge, but at least for a few hours each day I was thinking about something else.

January 19th I drank the ridiculous amount of water again. We went back to the same clinic. I was even more nervous. What if there was a baby there? Would it be healthy? How would I react?

The tech we had this time was much gentler, but within moments I knew. There on the screen was the same empty black blob. She probed a bit and then asked if I would be ok with her doing an internal ultrasound (and yes it is as uncomfortable as it sounds). I agreed and after another few minutes she shut off the machines. She told me not to lose hope. The sac had grown in the last two weeks. Maybe I just had my dates wrong. (If I heard that one more time, I knew I was going to hurt someone badly.)

We left the clinic, and I went home and cried some more. Again, we had an appointment the next day with our family doctor and he told us what I already knew in my heart. My HCG levels had dropped. I was miscarrying. Again.

The rollercoaster I had been riding for the last two weeks came to a screeching halt at the bottom of the biggest hill. It was over.

He told us that he didn't recommend another D&C so soon after the last one, and that he would prefer that I miscarry naturally if possible. It could take up to six weeks to happen, but in that time he would get us a referal to the OB that looked after me last time, in hopes of getting some testing done to find the answer to my biggest question... Why?

Less than a week after that appointment the cramps started. Lower back mostly. Then the spotting. I forced myself to continue to go to work because I couldn't put that strain on my co-workers again. Last Sunday night, while I was at work the miscarraige happened. It was frightening, disgusting, and heartbreaking all over again. The only good thing was that it was almost over and I wouldn't have to wait another six weeks.

In a quirk of coincidence, I had heard from the OB's office on the Friday before and he wanted to see me first thing Monday morning. So the morning after, still in a great deal of physical and emotional pain, we went armed with my list of questions.

My OB is quite possibly the nicest doctor I have ever had. He seemed genuinely sorry to see us again, knowing that I would only be back if things had gone wrong again. He listened to my list of, at time ridiculous, questions and answered everything. There is nothing we could have done to cause this and nothing to prevent it. It was likely a genetic abnormality that prevented the baby from developing past the embryo stage and my body reabsorbed it. The clinical term is 'blighted ovum'. And this was number two. We are now at an awkward crossroad...

Normally, testing does not begin until after the third consecutive miscarraige. But because of my age, my pre-existing health concerns (read: weight issues), and my need for answers, he agreed that we can start some testing. But which tests? After a few more questions, we determined that the best course of action will be to ensure that everything inside me is structurally sound. So, in six weeks or so (whenever my body gets back into a normal rhythm) I will be having an HSG (some incredibly long name that I can never remember). It is a procedure where they fill my uterus with dye that is visible on an xray. This will help them to see if there are any malformations inside that may be contributing to this. After that test, we will look at the quality of the swim team and then finally some genetic testing to see if either of us have a chromosomal abnormality that may be the cause.

The challenge now, besides the getting on with life, is waiting for answers that may not come. For all the advances in medical science, there is not a lot known about miscarraige and it's causes. We will likely not get a definitive answer. So, gentle reader you may be wondering why I am going to subject myself to these tests. The answer is simple... I need to be doing something. Anything. I need to know if and when I get pregnant again that I have done everything that I could to prepare myself for what may come.

So for now we wait. We grieve. We heal. Everyday there is another reminder that I'm no longer pregnant. A customer at work with a very pronounced baby belly, the Gerber commercial that has the power to disolve me into a puddle of weeping mess, the development emails that I forgot I signed up for and can't seem to stop. We try to look towards the future, not counting on a baby to complete our family. We plan our long-put-off honeymoon trip (New York in the fall).

And I try not to talk about her too much. I don't want to make people uncomfortable, but I need to let people know that I had another daughter. Another little girl (of course, it's only our assumption that she was a girl) to miss even though I never met her.

They say that motherhood begins with love. If that's the case, then I am a mother. I love my little girls. My little angels. I always will.

Olivia Noelle
Beloved Daughter
Gone, Forever Loved
January 20, 2009