Leap Day 2008

There is a soul that belongs to my first child. A perfect soul. A perfect soul requiring a body sufficiently perfect to do it honor. Not perfect, but perfect enough. And the body into which that soul was to be born was not perfect enough. A perfect soul with an insufficiently perfect body.

In the end, I find that I have been unable to accept that my miscarriage represented the end of the opportunity for that child to be born. Coming to believe this (or convincing myself I do) was, in many ways, the only way I got through the miscarriage last fall. Not that believing this made living through and with loss any easier. But it made the loss more like the loss of innocence and the loss of expectation and less like the loss of a child, though there was and is certainly a lot of that mixed in along with it. My heart breaks for women whose own experiences of loss make this belief of mine seem childish and delusional and useless. I am so sorry.

As for me, I lost my first child last fall, and I carry that child within me now.

What's strange to me is how much that ends up sounding like one of those terrible things that people say to you when they hear you've had a miscarriage and don't know what to say.

Feeling like a Hobbit

I had a bowl of cereal for breakfast at 7:30, which is not an uncommon breakfast for me. Normally this tides me over until 11, at which point I begin the countdown until it's an acceptable hour for lunch (that acceptable hour has gotten earlier and earlier lately. My high school had a lunch period at 11:20, which has apparently affected my judgment). Today, by 10, my stomach was growling, making second breakfast necessary. I'm currently working on a piece of whole grain toast and a yogurt.

Separately, I waited for P to leave for work this morning and pulled out the doppler. I found the heartbeat right away (as in within seconds), in the same spot as Monday, but with less of my own mixed in. DBTs are subsiding a bit. I also slept a lot better the last two nights, which is helping as well.

11w1d

(Sorry for the succession of posts -- our modem appears to be dying, so I wrote a couple of posts this weekend that wouldn't post and am only now able to post them from work.)

I had horrible insomnia as a kid (starting around age 6), which I only really got under control when I discovered pot in high school. (Look at me, being all honest and sh*t.) Before that, I just lived with being incredibly tired all the time. My parents and doctors were constantly convinced I had various illnesses that make you tired -- for years, I got tested for leukemia, mono, and anemia every time I had a doctor's appointment. Needless-to-say, I stopped smoking before we got on the conception trail and discovered that, after a few days, the insomnia had largely gone away. I have learned the cues that signal I am close to falling asleep, which helps to keep the anxiety at bay -- the anxiety that, of course, makes it that much harder to fall asleep.

Then, last night, I couldn't sleep. I just lay there. For hours. And it sucked. I sat there thinking and ruminating and stewing in paranoia and anxiety. The DBTs were overwhelming.

So I woke up this morning (feeling oddly refreshed for having gotten only a few short hours of sleep) and got out the doppler. And I couldn't find the heartbeat. I tried for a really long time. Longer than is probably safe for whoever is in there. And I still couldn't find it. After an interminably long time (like 35 minutes), I heard something. I'm going to call it the heartbeat, because anything else might send me into a terrible downward spiral. It was faint, but regular and at an appropriate rate (between 140 and 150). I could hear my own heartbeat interlaced with that sound, every 2-3 beats, much louder. whump-whump-WHUMP-whump-whump-whump-WHUMP-whump-whump-WHUMP. Not at all like galloping horses, as the manual proclaims it should sound. More like something you're not sure you heard at all but you tell yourself you heard because the alternative is TOTALLY FREAKING OUT (well, and because your spouse seemed to hear it too).

Sadly, I'm not feeling any better about the prospects of an easy sleep tonight. Two weeks to go until my next appointment.

11w0d

Eleven weeks feels like a big milestone, but the DBTs have been creeping in lately. These issues are partly sponsored by the letter P. P has been spending his evenings and weekends staining and polyurethane-ing furniture in our basement, and the fumes have permeated much of our house. It completely freaks me out, but he doesn't seem to get it. I know I was on him to finish this project (which he started a year ago), but I wanted him to finish it a year ago, not while I was in the first trimester of a pregnancy filled with fear and paranoia.

I know miscarriage rates drop significantly once you hear a normal heartbeat at 9 weeks, but I have a hard time believing that this statistic has anything to do with me. It feels remote and clinical. I think in part this is because no one I know in real life has had a miscarriage and gone on to have a subsequent pregnancy result in a real life baby.

My aunt miscarried when I was in college and was later told she wouldn't be able to carry another pregnancy to term, which put a lot of pressure on my then-little cousin. And very few of my real life friends have kids. I have one friend who has miscarried. She is pregnant now too. And we commiserate a lot, since we live in the same little freaked out place much of the time.

I feel like time is moving so slowly.

Baby Shower

I had one of those "it should have been me" days today. I was seated at the same table as a woman my old friend (whose baby shower I was attending) met online in a "due in April" chat room. They are both due the same week I was.

I was pretty impressed with myself. I held up surprisingly well. I was friendly and chatty and actually felt pretty okay. Until the conversation somehow took a turn in an unanticipated direction, and the various girls at the table started talking about when and how one tells others that one is pregnant. And that quickly turned into a discussion of women each of them know who have had miscarriages, and how those miscarriages have affected each of those women's decisions to tell people about subsequent pregnancies, and how knowing about those experiences has affected the women at the table.

I felt I had nothing to contribute to the conversation. Or, rather, I had everything to contribute to the conversation, but I didn't know any of these women and wasn't sure how much of myself I really wanted to put on this particular table. They were all talking about how you tell anyway because you would want support when things went wrong. Which I totally get. But some of us (and some of them, from what we had been talking about earlier in the lunch) have families in which telling one person and not telling another can cause rifts that never heal. And yet the person you "have to tell" is the last person you'd want to turn to for support. And that same person is unlikely to be able to keep a secret, so telling them is the equivalent of telling everyone they know, which makes for a huge long list of people to untell if everything goes wrong, and a huge long list of people who know and who will treat you differently in ways you really wish they wouldn't, because, with them, it's not about you but about them and about how they feel about your sadness.

In the end, I decided to jump in and risk being a hardcore downer. And they were more supportive than I ever could have imagined or expected -- more so than many of my real life friends who know. It was a pretty amazing experience.

That said, I cried most of the way home, sobbing and choking on my tears in a way I haven't for a while now. Apparently the brave face is still just a mask, and the sad, scared me still lives inside, just under the surface.

The Sweetest Sound

My general lack of impulse control resulted in the purchase* of a fetal doppler last week. It came yesterday. Last night, I ran upstairs with it, spent some time figuring out how to put the battery in, then covered myself in goo and gave it a whirl. For a while, I kept hearing my own heart and only my own. I finally moved the wand to the left a bit, and there it was. Whump. Whump. Whump. Whump. The sweetest sound.

I opted not to read the directions beforehand, so I had some difficulty figuring out how to get the digital readout to work and instead just counted. 158bmp. Not even remotely abnormal. Not slow. Not starting and stopping like the first time. P was truly amazed. I think he could have listened to it all night long. I know he wants to try tonight to figure out how to use the record feature so we can listen to it whenever we want without traumatizing the little one.

It occurred to me then that I had been opting to fake it til I make it thus far. After hearing that sound, for the first time I actually let myself believe that we might bring a baby home in September. All of a sudden it feels a little real.


*When researching rental, which was what I was considering at the time, I discovered that one of the rental companies also sold them. The prices on their rental website for purchase were far too high to justify purchase, but they also have a store on e*Bay, where the purchase price was actually the equivalent of only a few months rental, plus I can keep it and use it again or loan it to friends.

Miscarriage News Round-Up: First Half of February

The following articles appeared in the first half of February:

• A fairly short piece in the Chicago Daily Herald raising awareness of miscarriage, its possible causes, and testing that can be done in cases of recurrent pregnancy loss.
• I'm a bit uncomfortable about the source of this bit, but it appears that France's Supreme Court has ruled that parents who miscarried may register names for their children regardless of the stage at which the loss occurred. They may also recover the body of the child from the hospital and may be entitled to take maternity leave.
• British footballer admits to having lied when he said he missed games due to the deaths of his grandmothers, later saying the truth was that his girlfriend miscarried. Do people have that little sympathy for miscarriage that we have to invent the deaths of our elderly relatives? And/or does this guy just have other issues?
• Doctors in Colorado performed a cauterization surgery to prevent the loss of twins to TTTS. For some reason, TTTS ranks high on my list of things that scare the crap out of me, even though I'm not having twins, so this calmed my fears a bit for everyone I know pregnant with twins sharing a placenta.
• According to this story, a woman in the UK is told she miscarried and offered a D&C or the drugs to hasten the process. She decided to wait to miscarry naturally. A month later, she learned she was still pregnant with a healthy fetus. These stories also scare the crap out of me. Additional coverage here.
• Additional criticism of the study linking caffeine consumption and miscarriage risk (and the hoopla that followed) available here and here. Additional positive article here.

My Grandma's Immeasurable Sadness

On the way to see my moms to give them the news yesterday, we stopped by to see my grandmother (fairly briefly, as my mother kept calling to ask when we'd be there). She is in decent health, all things considered. She is overweight, smoked for 60 years (quit 8 or 9 years ago, leading to much of the extra weight), and will be 90 this year, but her heart is in good shape physically and her doctor routinely gives her a fairly clean bill of health.

But while her heart is in decent shape physically, the emotional trauma it suffered when my grandfather died in his sleep 10 years ago has left it broken, growing more fractured with each passing year. And this has left her without any joie de vivre. I'm not sure how often she gets out of her living room chair anymore, even though she gets around fine with her walker. I know she goes to the dining room at her retirement home for dinner, but she turns down all invitations to do anything else (or accepts, then backs out at the last minute), so people (friends and family) have stopped asking. She has, for the past few weeks, refused to have her hair done. She doesn't read any more, or watch TV, in part because her eyesight and her hearing are both bad, and she refuses to do anything about either one. And, because of the hearing, she is terrible on the phone.

Her refusal to do anything but sit and await death has, predictably, begin to impede her cognitive functioning. She no longer has any stimulation to keep her mind going, so it's starting to slow down. And as she loses her short term memory, she retreats deeper into the past, struggling more and more to find anything to enjoy in the present or to look forward to in the future. And this creates a vicious cycle. It shocks and horrifies me that, until I did so yesterday, no one in her life has suggested that perhaps anti-depressants might help with some of the emptiness and loneliness she feels. They may not help, but neither will failing to consider them.

Seeing her like this overwhelms me with sadness and truly breaks my heart. This woman went to Radcliffe. She taught science because it gave her great joy to share her love with young people. She is an amazing woman who still has so much to give. My grandfather was never willing to travel, so she never did any traveling either. He thought overseas travel was too dangerous, so she never went to England, which was her lifelong dream. But, for my twelfth birthday, she did take her first real vacation -- we went to Bermuda, just the two of us, and had a wonderful time. I wish I knew what to do to give something back to her and, especially, to make her stop hoping for the end of it all.

For reasons of family politics, I knew I couldn't give her the news before my moms, so we'll have to make another trip down her way in the next couple of weeks to share our news with her. She hasn't been particularly excited about any of her five great-grandsons (my cousins' kids) thus far, but I also know I've always been very special to her (and was to my grandfather as well). I lived close by when I was little, so I saw her often. Plus, I'm the only girl grandchild or great-grandchild, as she reminds me each time I see her. Finally, unlike anyone else in the family, she always felt I took after her side of the family, both in appearance and personality, and points it out often. I'm really hoping our news will bring a little light to her life and give her something to keep living for.

The aforementioned u/s photo

As I said before, it's a bit weird looking. My bladder was empty, so everything looks squished by the wand without the bladder as padding, and she took the photo while taking the measurement, so it's not the best picture, but here it is.

Telling people

Even though it makes me terrified that we're jinxing things, we started the telling people process. We told my MIL last night -- she got to be first. We tried to be cute about it, and it didn't really feel like us, but we did it anyway. We told her we'd gotten her a Valentine's Day present. We got her a congrats on your new grandchild card but put it in a Valentine's Day envelope so she wouldn't know what it was. We got a I Love My Grandma frame and put a picture from the u/s in it.

She cried. Then she got out all her childbirth materials (she was a labor and delivery nurse and also taught childbirth classes, as well as breastfeeding, infant CPR, etc.) and scared the crap out of me. And then she told me she had a box of baby clothes she had accumulated over the years to give us. (That was actually surprising -- she's really not the type to stockpile things for future grandchildren. Apparently she was egged on by my SIL, who thought her mother should be accumulating things for her own future children and for ours.) We talked about the miscarriage too, and it felt good to be able to talk about it with family. It's felt like a really shitty secret that we've been carrying around for months. All in all, it went well.

P only has one parent, whereas I have three. So one down, three to go, but it's sort of like we're half done. We'll tell my moms this weekend -- we'll do it the same way, but are trying to find a way to make an S to add to the frame, since they don't sell lesbian-themed grandma frames, it turns out. My dad is on vacation, so we're still trying to figure out when to tell him. He's the one I'm most nervous about. I'm a bit of a daddy's girl, and even though I'm 30, married, a lawyer, and own my own house, I think he still thinks I'm too young to have kids.

9w1d

9w1d. That is what I am, and what the little one was measuring. The doc said the heartbeat looked strong and healthy, but she isn't as adept with the ultrasound machine as the midwife so she didn't measure the rate. Because the ultrasound was external and I didn't have an even-remotely-full bladder (I had just peed in a cup), the picture is a bit blurry (and the sac looks smooshed from being pushed by the u/s itself) -- I'll try to scan it later, but it's not too impressive looking. We did get to see it move it ginormous head, though :)

The relief I felt was astounding. After the scan, the rest of the appointment is a blur -- I couldn't even remember if I had any questions so I didn't ask any. We go back to see the midwife at 13 weeks, then the doc again at 16. In the next couple of days, we're supposed to be thinking about Downs screening -- we can do none, the 11-13 week NT scan and bloodwork, the 16 week bloodwork, or sequential -- a combo of the latter 2 with no results released until after the second round of bloodwork. I was so scared we wouldn't get this far that I haven't given it any thought at all. As P pointed out, we are now in uncharted waters, as it was at our 9w1d appointment last time when we learned the little heart had stopped beating.

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Thanks everyone for the advice re the first ultrasound. The general consensus (between responses here, at my favorite message board, and via email) was that it was probably (1) nothing -- people had seen similar things on their early ultrasound or on an ultrasound they saw online; (2) a bleed of some sort (but I think those usually cause bleeding at some point and I haven't bled at all); or (3) a fibroid. Whatever it was, it appears to be gone now, so I'm guessing it was (1).

Also, I probably should have been clearer re the fear of being fired. First, it wasn't my fear. I know my doc isn't going to fire me for asking questions. It was Ps fear. Second, I don't think he really thought she'd fire us -- he just didn't want us to come off as demanding patients. And this isn't his general mentality -- it's because our doc is a friend of his mom who has known him all his life. I haven't hesitated to call her with random questions before and don't intend to start doing so now, but I also wanted to respect his wishes on this particular issue this time, especially as we had an appointment coming up within a week. Either way, whatever the weird stuff was, it wasn't there anymore, though the cyst on my left ovary hasn't shrunk.

And as for the receptionist, it's her job to do scheduling and to follow the particular schedule the doctors generally use, which means seeing a doc for the first time around 9 weeks (my 6 week midwife appt was a week earlier than their 7 week one because I asked for it). When she pushed it back a week from what she originally scheduled, she wasn't trying to be mean -- she was just following normal procedure with the benefit of a calendar, which she hadn't initially used. I would have been happier with an earlier appointment, but wasn't mad at her for doing her job. But thanks for being mad for me :)

8w4d: The 6w2d ultrasound images

My original second appointment was scheduled for the 4th, which would have been earlier this week. The receptionist then decided that I shouldn't come in again that soon and moved it to the 11th. P is convinced that if I ask to have the appointment moved up, the office will think I am demanding and fire us as patients. Therefore I haven't asked. I can suck it up until Monday.

Part of my anxiety stems from the fact that, to me, my first ultrasound didn't look quite right. Yes, we saw a heartbeat, but there seemed to be other things in the sac with the baby and the yolk sac, things the midwife described as "and don't worry about the rest of that." Of course, since the initial elation wore off, all I've done is worry. This is another thing P thinks they will fire us as patients if I call to ask about. So I'll ask all of you. Do these ultrasounds (one bigger, the other with the heartbeat and therefore smaller but with a somewhat clearer view) look normal to you? Can anyone describe what all everything is in here?

In this one, she said the thing being measured was baby, the thing to its left was yolk sac, and the thing that looks like a kangaroo kicking it in the back was the thing not to worry about.

This one, the heartbeat is on the bottom. But the ultrasound above it looks clearer, so you can see that the tail of the kangaroo looks to be attached to the wall, creating some sort of fluid-filled-bubble-like structure to my untrained eye, which makes the whole shape look less kangaroo-like.

You can help me sleep much better for the next five nights (well four, since I'm heading to bed now and any thoughts you might have won't reach me until tomorrow) if you can provide any insight. Even if the insight is negative (e.g. that is a sign of a failing pregnancy, or some such thing), please let me know. I don't deal well with limbo.

8w2d

Last time around, at what we later concluded was the point at which something went wrong, I started having dreams that I was caring for other people's children. I had such a dream last week. And I had another one last night. These dreams have left me with a dark sense of foreboding.

That sense of foreboding has been seeping in more pervasively over the past week, and not just because of the dreams. I have always fought the twin demons of depression and anxiety, and I have generally been victorious. But they seem to have been steeling themselves for battle of late. Days are filled with depression, which is in part why I am having such a hard time at work. Nights are especially bad for anxiety. I just want my next appointment to come so at least I can have a chance to breathe a little, feel a little bit of confidence, know that we at least made it further than last time without any sh*t landing upon the proverbial fan. And if the appointment doesn't let me breathe easier, feel any confidence, or bring any positive knowledge, at least the depression and anxiety won't seem so inexplicable and pointless anymore.

Six days until that appointment. If it goes well, we're telling our parents. If it doesn't, I have no idea what I'll do.

Miscarriage news round-up: The rest of January

To start with: the caffeine stories:

• As everyone read and reported on last month, new research to be published in the American Journal of Obstetrics and Gynecology has shown that caffeine consumption in excess of 200 milligrams per day can increase the risk of miscarriage twofold. Many organizations have modified their recommendations regarding pregnancy and caffeine to reflect these findings, most now advising pregnant women to cut caffeine completely. However, in addition to accolades, the study has also received criticism for a number of reasons. One criticism was that the study was self-report (based on a single interview) and non-random by design (as conducting such a study in a randomized way would be unethical), and while researchers endeavored to control for confounding variables, such a design makes that far more difficult. Further, the study described women as falling into three categories -- those who consumed no caffeine, those who consumed up to 200mg/day, and those who consumed more than 200mg per day -- but did not report average amounts of caffeine consumed by those in each of the two consuming groups. For a few articles discussing the research (and criticism in some cases), see here, here, here.
• Relatedly, other research published in Epidemiology in January suggested no increased risk of miscarriage for women who consumed moderate amounts of caffeine in early pregnancy. For an article discussing this research, see here. Apparently such a finding was less interesting to the press.
• Finally, Newsweek saw this study as a jumping off point for a broader discussion of miscarriage risk factors.

In other news:

• According to this story, in Malta, a woman was given a six-month suspended sentence for causing a woman whose car she hit to miscarry through her negligent driving. The other woman was twenty weeks pregnant at the time. Too bad the court can't order that the sorrow of the woman who lost her child be suspended as well.
• Apparently, in Scotland there are several memorials to children lost before birth, meant to provide physical locations for families that have suffered loss to channel their grief. Those seeking to set up a new one are soliciting the views of those touched by miscarriage regarding how best to proceed.
• In celebrity news: Lily Allen suffered a miscarriage in January. Additional coverage here, here, here, here and seemingly everywhere else. Cruel and callous coverage here. Dominican singer Anais had an ectopic pregnancy. Original story (in Spanish) here. Finally, the wife of country singer Joe Nichols also had a miscarriage in January.

Watching your team lose the Superbowl sucks. Watching your team lose the Superbowl and being unable to drown your sorrows really sucks.

A Few Things I Am Not A Fan Of

This is the post where it becomes obvious that I am a bit hormonal (and a serious bitch when it comes to nit-picky points of grammar, some of which may be more matters of preference than rule anyway). Here are some things that I am not a fan of:

• Nosebleeds and this whole bloody snot thing (sorry).
  
• The fact that we have been so socially conditioned to think sex is a dirty word that we use gender when sex is the appropriate word. Sex historically meant male v. female. Gender historically meant masculine v. feminine. (It's also sad that dictionaries have been modified over the years to reflect this social shift -- screw you, dictionaries.) You are unlikely to be able to find out your child's gender by ultrasound. SEX. SEX. SEX.
• The fact that I am too afraid of miscarriage to have sex. SEX. SEX. SEX. I am having none of it.
  
• Niobe touched on this the other day, but another pet peeve of mine is people's inability to correctly use which and that. Which is not the formal or more educated sounding version of that -- it's actually its own word with its own proper usage.
• The fact that my neighbors' dogs get out constantly, and I seem to be the only one who is concerned enough about them to corral them and get them home safely. We live a block and a half from the highway and a block from a major state road! And these are not smart dogs! I am not sure which bothers me more -- that they get out or that NO ONE ELSE CARES (so I end up walking the streets at 8 a.m. in my pjs holding my dog's old leashes trying to call 2 dogs, one of whom runs at the sight of me).
  
• People who persist in write things like "I should of called sooner." HAVE, damn you. What are they teaching people in school these days?
• Homophobes. Get over yourselves.
• The fact that P only does the laundry when there is something in the hamper he needs. Is one of the hampers full (we have three bamboo hampers -- darks, lights, and whites)? Run a load of laundry! Even if you don't need anything. Please stop putting clothes on the floor next to the hamper and waiting for me to do it.

Okay, I've done enough to make it clear that I'm a bit of a bitch for one day.