12/8/2011

At the beginning of the week, I had three people make pregnancy jokes based on my vivid dream and a patty melt desire.  Then this morning I found myself unable to tolerate mint.  I have a Mirena  IUD, but figured a little reassurance never hurts so I dipped a pregnancy strip.  Now, I’ve done this twice before since I had the IUD and it was nice and reassuring to see that negative result.  A bit different this time, the strip showed the test line before the urine had even gotten to the control.  Unexpected would be an understatement.

Called obstetrician’s office and they called back about two hours later and scheduled me for an ultrasound about half an hour later.  Went in, checked in and was still reasonably calm.  I find it a bit prophetic that I’d set a post on the idea of Just Another Day in Wileydise to post that day, but I was approaching it all pretty calmly.  Had called and told Paul and he said to just breathe and wait until I had information.  I figured it was likely early enough that if it was ectopic (high risk with an IUD), it could probably be easily managed without too negative health implications hopefully.  I figured if it was a chemical pregnancy or otherwise miscarrying, I could deal with that and understand it as part of the risk of getting an IUD.  I figured that if it was a viable intrauterine pregnancy we could figure out making it work even though it wasn’t planned.  Really thought I was ready.

Then the tech started the scan and I saw two gestational sacs.

She measured two gestational sacs.  She said she couldn’t comment on anything or even confirm that I was seeing two separate pregnancies or whether they were in the uterus.  She did label them right side gestational sac and left side gestational sac, so between that and having previously seen an early twin ultrasound, I felt pretty sure it was two.  When she finished, I went back upstairs to see the doctor.

My blood pressure was 160/98.  It’s normally about 105/58 or so.  The tech who took it seemed a bit concerned by this, but said that they would probably just check it again.

The nurse and the doctor came in and asked how I was or something to the effect and I responded with, “my blood pressure is a bit high.”  The doctor said she thought she knew why and I for some reason thought this meant she knew something was pathologically wrong and had seen on the ultrasounds and so asked what.  Apparently, she just meant the knowledge I’d just gotten.  I then asked her if I was right in thinking I’d seen two sacs there.  She confirmed this to be the case.  Only one of them had a measurable fetal pole, but the other one could either not have one because it is not developing or not have one because it’s still too early.

Apparently knowing the days I bled or spotted doesn’t help in the least bit in dating the pregnancy as they typically have nothing to do with ovulation when you have an IUD.  The one measurable fetal pole was 5 weeks and 6 days, but apparently size is really hard to measure at this gestational age, so could be anywhere from about 4 to 7 weeks. 

It was a bit of an interesting balance as an appointment, because we were both looking to find the right point between getting me all the information that I needed for the sake of my understanding and not borrowing trouble or worrying about something that we may never get to that point.  My OB knows me well enough it seems that she gets that I have a lot of questions and like to understand as much as possible, so I’m feeling as informed as I can be in a situation that is definitely unclear.

So, where do we stand? 

·         I am currently pregnant. 

·         I am pregnant enough that looking at beta HCGs won’t really give any good information as to the viability

·         There are two gestational sacs

·         The IUD is out now which improves the range of outcomes

·         I do not have an ectopic pregnancy

·         We will do another ultrasound in a week to look at the growth of the two potential fetuses

·         My cervix is closed and looks good

So right now the only directions are to start taking prenatals (I finally stopped a month ago as a great example of irony) and allow time to pass until the ultrasound and appointment next week.  My doc's nurse actually stayed in the room while we were talking so she could be up to date as I'm supposed to call with any questions at all that I have.  My doctor has said she will definitely keep answering my questions and provide as much information as is possible.  I'm supposed to call immediately if I have bleeding or cramping because while there is nothing we can do about a miscarriage, knowing is good. 

As you might can guess from my oversharing with the internet, I’m a fan of discussing and working things out through talking, so I discussed this with a couple friends more or less while it was going on (in addition to Paul who despite his wonderfulness and awesome nature is definitely male).  One of them asked me after if I was ok.  My answer: “yeah, I really am.  Still definitely a lot of stress, uncertainty, fear, worry, apprehension, anxiety and the like, but I know where we are now, I know what the plan is, and I know it will be fine even if it isn't now.”

I’m having trouble thinking of an uncertain situation I’ve been in before where I’m unclear what sending positive vibes or rooting for would mean, but I’m not sure in this case.  I definitely don’t want a miscarriage, but I can acknowledge that is would be simpler in many ways.  A singleton pregnancy would be less risky than twins, but I can’t imagine myself rooting for that either.  So I think I’ve settled on I’m accepting whatever reality will be and I will deal with it as it comes. 

I debated whether or not I should write this.  On some level it seems odd to write about a pregnancy that is more likely to result in loss than not (how’s that for some scary statistics, and I thought normal miscarriage stats were bad), but even if I do miscarry (the main reason it’s so likely is apparently because of insufficient lining due to the IUD), that won’t unmake it happen and will still affect my thoughts and the like.  My main worry for sharing is that I really don’t know if I could stomach any more sympathy from people in our lives.  I know that sounds even weirder, but it’s true.  But there are only a handful of people who I know that read this and I would definitely tell them regardless, so it seems to make more sense to document my thought process and feelings than to not.

In terms of telling people in normal life?  My thought is wait as long as possible because there are a lot of people that just don’t ever need to know if it does end in miscarriage.  We might tell our parents/siblings at Christmas if next week’s ultrasound shows progress, but it definitely isn’t a happy go lucky pregnancy and will only be telling people who are central to our lives and need to know as such rather than just for congratulations or the typical responses.

It’s been almost four hours since the ultrasound and my pulse finally feels about normal.  You know what?  Life happens.  We respond.  And that’s the beauty.

And one more last thought (and yes, the idea on one more last is funny).  Am I odd that it’s the second one that blows my mind?  I mean the idea of being pregnant on an IUD with an almost one-year-old seems like it should be pretty mind-boggling, but that seemed manageably so.  It was the presence of a second one that really just ran me over like a Mac truck.

I’ll let you know how things go either way.  Interesting fact: they don’t give you copies of the ultrasounds apparently when they anticipate you are going to miscarry.

Oh and yes, I do see great irony in this happening right after I'd basically come to the conclusion that I shouldn't be pregnant again for the sake of sanity.  And no, I'm not ready to think about the insanity aspect yet.  What's nice is for some reason my fear of babies dying doesn't extend to miscarriage.  I see that as more of an inevitability or something, so not having the obsessive thoughts of last November/December.

One positive is hopefully this will quickly get me over the fear of going to the OB by myself.  As I've said before, the appointment where the demise was found was the first time I went to the OB or the perinatologist by myself between either pregnancy.  Well, I went by myself today and since the only time the schedule worked for next week was during Trajan's winter performance, I'll be by myself again.  Luckily, Paul has been really supportive and helpful in my thinking all of this out over such a short period of time and I really think that's a large part of the reason I can say that I know that I am ok. 

Speaking of Trajan, regardless of whether we end up telling the grandparent types, I am pretty sure we will not be telling him unless it is at a point where there's basically no other option.  It may be selfish, but I don't want to hear him explaining death again.

Notice that I'm no longer even calling anything "last thought". 

And yes, I totally get that intentional termination is an option.  That said, I just can't do it and have no desire to.  I can't consciously choose to kill my child.  I know what it is like to lose a child in reality, not just as an idea, and I know that I am not strong enough for that.

Just Another Day in Wileydise

I have thought a lot about what makes us who we are in the last year.  What makes some people take adversity and become more than they were through it while some justifiably just more or less give up?  What makes some people able to stay who they are regardless of what is going on around them while some change like chameleons?  What causes some people to spend a lot of time reflecting and ruminating while others are able to move on and deal more with just the now?

I am in the former rather than the latter category for each of these and I think the reason for each comes down to two basic things: an attitude of resilience and a commitment to being what you see is what you get.  I think the title of this blog, Just Another Day in Wileydise, really conveys how central both of these ideas are to me.

I started this blog back in August 2010 while pretty newly pregnant with the twins on a random whim.  It was at least the fifth blog that I’d started, but I’d never written more than a couple entries (I should perhaps move the handful of entries over here just for amusement) on any previous one.  I think part of the reason this one lasted was the attitude that went into it as reflected in the name (Aurelia’s death also probably increased the likelihood that I’d keep posting).  My first post dealt with why I picked the name Just Another Day in Wileydise and I read it today for the first time since I wrote it and I’m struck by how appropriate it is.

At the time, I wrote that “I was looking for a blog title and the two thoughts that have been most in my mind in the last couple weeks are Life Happens and Just Another Day in Paradise.”   I didn’t know how true these words were at the time.

Life happens, things will come at us.  It is what we make of them that determines our existence.

While I obviously think that our nature matters a lot, it’s also clear that the friends and family and support that we have are very important. 

One last thought.  It just struck me that the non-Texans reading this might not get the Just Another Day in Paradise reference.  It’s the title of a country song by a guy named Phil Vassar that portrays a lot of the banalities of life and celebrates them as being really the definition of paradise.  I think he’s got it right.  It’s the hustling around in the morning to get ready together and the time spent together as a family that really defines our paradise.

So I now take the title to mean two things.  First, that no matter what happens, it's always just another day and we just need to respond and react and second, life is wonderful and little things like a boy and his dog or grocery shopping really are what it is all about.

Truths I have learned in the last year:

There are no right words.  But no words is definitely wrong.  Just an “I’m sorry” or “that sucks (perhaps with a bit of profanity thrown in)” goes a long way to making the individual still feel connected to the world.

Perhaps the worst aspect of grief or catastrophe is the sensation of being alone in the experience.  The power of making a connection with someone else who has experienced something similar really amazed me.

Joy and sorrow can go completely hand in hand.  I found a flip camera recently and there were some videos from the NICU in Chiron’s first week were Paul and I are laughing and joking.  In retrospect, it amazes me that we experienced anything other than anxiety, grief or just plain being overwhelmed.  But in the moment, the entire range of emotions can occur.

Macabre humor can be one of the strongest weapons in the arsenal to deal and continue functioning.

People are greater and stronger than I knew.  The strength and compassion of our friends and family in supporting us has floored us and continues to do so.  Humanity and our connections to each other I now am convinced is the main source of our strength as a species.

There’s a catch-22 in the loss of a child: others don’t want to bring them up because they fear it will make you sad, but it is much easier to discuss them when the other party is the one who “remembers” their existence.  I think this was particularly pronounced in my case as I have had so much trouble with vocalizing her actual name instead of just using pronouns.  Did it right there, see?  Aurelia.

There’s an Elizabeth Edwards quotation from a speech she gave in Cleveland that I think communicates the truth about discussing a dead child amazingly well: “If you know someone who has lost a child, and you’re afraid to mention them because you think you might make them sad by reminding them that they died—you’re not reminding them.  They don’t forget they died.  What you’re reminding them of is that you remembered that they lived, and … that is a great gift.”  In our case, Aurelia never lived, but I still think this is true.  And based on some friends I have known with miscarriages, I think it remains true there as well.

On the Elizabeth Edwards train of thought, I think she is on to something with her quote on resilience.  It was going around the internet about the time the twins were born and stuck with me: “Resilience is accepting your new reality, even if it’s less good than the one you had before.  You can fight it, you can do nothing but scream about what you’ve lost, or you can accept that and try to put together something that’s good.”  I believe this is what we have done and our family is stronger for it.  I didn’t notice it at the time, but my philosophy I wrote about really is the same idea as what she said.

Seeing the flipside has only resulted in positive outcomes.

Someone connecting with what you are thinking can be incredibly powerful.  When Chiron was born, the most common statement was "Congratulations!," even from the nurses in the antepartum area.  While based on the very first truth, say some words, this was appreciated, it always felt a little awkward to me.  Were they congratulating me for delivering my son over ten weeks early?  This seemed odd to me.  One person said the exact opposite, "I'm sorry."  And she said this in the context of Chiron's birth, and I remember being so struck by her ability to acknowledge what I was actually feeling.  I don't think it is chance that this is a friend who has struggled with infertility.

The effect of someone including your dead child's existence as a part of their universe is powerful.  I'm pretty sure the passing comments, texts and messages that acknowledge Aurelia either directly or indirectly, through recognition that I have been pregnant with a girl child or with twins for example were made with no idea how much they could make me smile.  Thank you.

There's a semi-secret community of people who have lost children.  And whether through miscarriage, stillbirth or death as a child or an adult, everyone apparently belongs and that is nice.

There is no way to quantify grief.  I still try to think about whether one type of loss is better or worse than another, but I should know by now that you just can't rank these things.

Labels will always be hard.  The one in particular that I really have trouble with is whether I'm cheating somehow to count Aurelia as a stillborn child.  The strictest definition typically seen is at least 24 weeks and 500 grams.  She died just past 24 weeks and was born at 30 weeks.  When she was born, she only weighed 397 grams (though for some reason, this is the only number I don't feel completely certain on).  However, she weighed less because she had been dead for six weeks than she did at the time of death.  So, I think she probably does count.  And I know multiple babies who were born at the gestation she died who are alive and even developmentally normal.  I just feel like I'm cheating calling her a stillborn next to those who deliver full-term stillborn children.

The mind of a child enhances existence, even the hard things.  Trajan's understanding and processing of the last year has strengthened me and helped me in my own processing.  He and his mind remain the thing in the world that most amazes me (just starting to see this in Chiron as well). 

I am blessed.  And lucky.

Resilience.

I think this is a phenomenal word and concept.

Bad things may happen.  It's what we do with them and how we manage ourselves that matters.  You can not judge or structure yourself by the things that happen to you, they mean nothing.  It's the conscious decisions and actions that you choose that matter.

I even remember reading an NPR story about how the trait of resiliency is one of the things most closely associated with a life expectancy.  Sadly, a quick search couldn't find it, but I found this and it was interesting.

Parenting Treatises

I stumbled across something in the notes section of my phone I wrote when Trajan was about 2.5 that I think is worthy of review:

Don't sweat the little things, know and stick to your big things, be willing to discuss and explain anything, including the big ones, even if it's the nth time.

To be completely honest, I've never really sat down and tried to think out or write out my parenting philosophy.  I know a lot of people who have and it seems like a really useful thing, but just never have and not getting there today.

I have however, identified a few basic elements that would compose my parenting treatises if I wrote them.  First is seek moderation.  In almost everything.  I really find that extremes just don't work for our family, so I really do consciously seek out the moderate path.

Second is own your choices.  It doesn't matter what they are, I think that as a parent I should be comfortable with them.  Even if they aren't something that I think most people will agree with or like.  While small children might force you to do this some since they present their reality honestly, I think it's important to make a conscious effort to be conscious of your decisions.  This also means you need to make decisions instead of just letting them happen by default.

Similar to owning your choices, I think it's important to consciously choose your battles rather than let them happen by default or through frustration.

Take these three ideas and roll them up with a conscious effort to not sweat the little stuff and choose to breathe rather than react and you've got my basic ideas.

I probably will never get around to writing a parenting treatise, but I think I'm on the right path to identifying what the key parts of it would be.  Probably plus some thoughts about how I recognize that my actions probably teach my children more than my words.  It may not be formal, but it works for us and I own it.

Philosophy

I was talking to a friend yesterday morning on google talk.  She's in Africa, so was around for an early morning chat.  She asked something to the effect of how am I and said she had been thinking about me and my family.  My response was:

I've got a good life.. things happen and while I don't have to like them, I've gotta accept 'em

It didn't really strike me at the time, but I noticed later that she had changed her status to this line.  That made me think about it and I think it's true and I think I like it.

I've been bothered recently by something that might seem odd, I've been bothered that I'm not too upset, that I am able to laugh, love, enjoy and even do the day to day banalities of keeping life moving.  But as I think about it, I don't think this is a problem.  I don't think there is anything lacking in me.  It's that rather than being the plot of the movie of my life, Aurelia forms part of the soundtrack.  She's there and will always be there, but as something that has helped to shape me rather than something that has in anyway broken me.  I am more than I was before her.

In the last week or so, four friends have independently either talked about her, written me a note about her or just asked me about her.  I like this.  I think it means that I am strong enough that others can tell that I have her as a part of my life and acknowledging her doesn't hurt me, it just is a part of me.

This is a ramble, so I think I need a conclusion.  She wasn't created and then died to be my angel, to absolve for my sins or in any other way rise above the plane of existence.  She did exist though and she did impact not just myself and my family, but others that connect to us in rings like the currents that spread out from a tsunami.  She mattered and like our family, her story isn't complete, even if she never breathed a breath.

I do have a good life.  I am blessed.  It's not just a question of resiliency, I think it's taking the effort to really appreciate.

Toes are evidence that the world is a wonderful place

See the Flipside

I said it once, but I need to remind myself, Attitude Matters.

I got stuck in meetings and discussions yesterday afternoon at work and so had to leave to pick up the boys having not pumped since noon or one or so.  So, I told Trajan that we would need to pump when we got to the house and then get on with our normal stuff.  He followed this up with a question of why.  I without much thought said something to the effect of "because Chiron likes milk." His response was "yes, but we need to pump more because of the hospital babies, right?  The sick babies need milk and so we pump extra to help them."

Stopped me in my tracks.  I've been whining about pumping, because it's a hassle.  But it took my three-year-old to drive home how important it is.  Not only am I providing Chiron with the food that is supposed to be best for his reflux, but I am also helping multiple preemies and sick infants.  Donor milk can be the difference between life and death due to NEC.  So, thanks Trajan.

Similarly, I've had this odd funk about the fact that Trajan will never have the luxury of just assuming that a pregnancy will be fine.  (Yes, I have been bothered about something my three-year-old might experience whenever he becomes a father.  I never said I wasn't crazy).  Well, I didn't see the flipside of all he has learned from this experience.  That life is precious.  That amazing things can be done.  That science and study are all important. 

My three-year-old declared the other day that there are some things that doctors can not fix.  Not a sentiment that you normally hear from a three-year-old, but it's true.  And I think his awareness of this is good because he also coupled with a statement that showed an understanding of personal responsibility.

So, time to see the good.  To see the magic.  To see what has been learned and achieved and conquered.  It doesn't mean I will not be aware of the sad and the bad, but I want to make a conscious effort to see the flipside.