Tuesday, July 31, 2007

On Nausea and Normality

On Friday, thanks to Motrin or Vicodin or anesthesia hangover, or the demise of the anti-nausea patch placed behind his ear before surgery, J~'s nausea kicked in. On Saturday, he threw up more times than I could count. On Sunday, after two days without painkillers of any kind, he still hovered around the bathroom in that hunched-over abdomen-curled-in pose of debilitating stomach distress, but never knelt before the proverbial porcelain god. Sunday, he felt well enough to expand his diet of Pepsi and Saltine crackers to include cereal, sandwiches, and mango sorbet. And yesterday, we even went so far as take-out Thai food.

I've been too damned exhausted to cook, let alone clean, though there is some improvement, for me as well, today.

Speaking of me: I've had no bleeding whatsoever for the past ten days. Breast tenderness continues. As for nausea, actually, yes, there's been some of that, too. Not as severe as two weeks ago, but undeniable. (If nothing changes by next Monday, and J~ is up for the trip, I will try for another ultrasound).

On the phone the other day, my brother asked how things were going, and I admitted, not well. In an attempt to be helpful, he looked for the philosophical silver lining, saying, "this kind of thing might make you appreciate normal more."

"I was appreciating normal," I whined, not quite sure if this was true.

"I don't believe you," my brother ventured, and I realized, I didn't want or need to continue this conversation.

But it haunted me for hours.

My mind wheeled through the last year, the last two years, the pain of my divorce, the miracle of J~, of this sudden new home in the country, the struggles I've faced with step-parenting, with pregnancy.

And then it hit me: I didn't need to put a positive spin on what was happening in my life presently, or take on any obligation or determination to "appreciate" anything.

If there's anything I've learned in the last two years, it's this: There is no such thing as normal. If there is, then normal has to include this pregnancy roller coaster, watching impotently as your beloved suffers, and the sometimes painful uprooted feeling of my newly rooted life. More globally speaking, it has to include a state of war, of environmental crisis, of extreme financial disparity. It has to include everything, both beautiful and horrific, and every emotional response, including hanging up on someone who loves you and was only trying to help.

Ugh. Things get messy sometimes.

Thursday, July 26, 2007

The Thick

J~'s surgery was successful. He is home, not feeling well at all, but between naps, he is out of bed and walking around, zombie-style. I can't tell you how relieved I am that he is still alive, not paralyzed, in one piece.

It was a rough evening in the hospital -- neck pain, difficulty swallowing, anesthesia wipe-out. He did not look good.

As for me, the long day of stress and waiting, with not enough food and then, finally, toxic hospital salad (with chicken basted in so much preservative it may well have been sitting around since 1972, with a dressing composed, undoubtedly, of high fructose corn syrup and not much else) culminated in a raging headache, sore throat, nausea, and weepy exhaustion. I finally got out of the hospital to head home for a few hours sleep, only to find my car wouldn't start. Thankfully, someone in the emergency room was able to give me a jump.

J~'s night was no better, what with the nurse's rounds every two hours, the literal pain in his neck, and an inability to empty his bladder, forcing a midnight catheter. The next morning, worried about a second painful syphon, he visited the bathroom repeatedly, each time managing to void a little bit more. After one last x-ray, he was released just before noon.

By the time we arrived home, he was feeling pretty rough, and so was I. After doing everything I could to make him comfortable, I wept and admitted I needed to lie down too.

It was a long, hard night. J~ slept in an upright position, snoring and gurgling and coughing so much I had to leave the room. When I awoke, in my stepson's bed (he was on an overnight with his camp) it was out of a dream that the miscarriage had begun, and into the worst cramps yet.

Two days after J~'s surgery, still trying to selflessly care for him in spite of nausea, headache, and cramps (but not yet bleeding), still weeping when I hit my strange new limit of extreme exhaustion, it finally occurred to me that, no matter the imminent demise, I am and continue to be pregnant. My body is simply not up for this.

B~'s grandmother had been a help, but not enough. Over J~'s objections, I called in reinforcements.

A good friend came by this afternoon, started my laundry, washed dishes, made lunch, and made me promise to keep asking for help.

Luckily, J~ is feeling better now, thanks, I think, to a switch from Tylenol to Motrin. And so am I, though no drugs were involved in my case.

My sister-in-law, who is normally tireless and an unswervingly devoted mother, said she also hit a mysterious rough patch in the weeks preceding her miscarriage, where she had to lie down and close her eyes and tell her kids to go watch television. She, too, thought maybe she was coming down with something. And then, hours later, just as mysteriously, the dark cloud passed.

Hearing this, I wondered: I know I was sleep-deprived and highly stressed, but perhaps it got so bad because of pregnancy transitioning into not-pregnancy? Perhaps it takes our bodies some great effort to derail that train?

Anybody else ever feel this?

Monday, July 23, 2007

Limbo

I thought I would have so much to say about this in-between place, about the slowly fading nausea, the slowly increasing crampiness. But the truth is, I've sat down more than once to attempt this post, and found myself, again and again, without words.

It's a similar experience every time I've picked up the phone in order to schedule one last ultrasound before J~ goes into surgery tomorrow morning. I have not been able to bring myself to dial the number.

At first I was hard on myself because I felt like such a wimp, shying away from the facts: Either it's dead already, I told myself, or it's not quite dead yet. Wouldn't it be good to know?

In the end, I decided to let it go. There are enough bitter pills in front of me. Why rush to swallow this one? Besides, judging by the level of cramps I feel right now, it won't be long before I'm bleeding again, before it's all over. I'm not there yet, and I'm hoping I don't get there before J~'s surgery, or before he is home on Wednesday. Ideally, not until Friday, when B~ goes to his mother's and his grandmother -- here to help out for the next few days -- goes on to visit her sister.

One brighter note: I feel incredibly blessed by all the support I am receiving, in comments on this blog, from my women friends in the area and from afar, from my co-counseling community (people with whom I take turns receiving and giving peer-counseling care and attention), and from family.

This is definitely a hard time, but I have been through far worse.

Thursday, July 19, 2007

When it Rains...

Warning: this post contains gory details.

It rained all day yesteday.

K~, my sister-in-law, woke up at four yesterday morning, feeling the first wave of cramps that would lead her, finally, to the miscarriage she's been awaiting for weeks. She, like me, preferred to let it happen naturally, rather than intercede with drugs or a surgical procedure, a D&C.

Since my brother, her husband, is away on a business trip, I and her mother arrived mid-morning to offer our support. While her mother took K~'s two kids out for errands and adventures, I spent the bulk of the day reheating hot water bottles and adjusting foot rests and making food and, most of all, sitting with K~ and telling her, yes, this is normal, this is the way it was for me, too.

By four o'clock, K~'s discomfort was at its worst. Finally, as the cramps began to subside, she passed what she thought looked like a miniature placenta, a dark red blob almost small enough to fit atop a business card. K~ wondered if the marble-sized whitish area embedded within it was a partially reabsorbed embryo. I told her I didn't know. My first miscarriage looked completely different - almost all white-gray tissue, smooth and tubular, not unlike a tampon in its size and shape. The second I don't remember as well. It happened so much faster. I was able to collect less of the tissue, but it may have been more like hers.

The third? The third seems more and more likely. Though I still have some nausea in the mornings, it subsides, and I have mild cramping all day. No bleeding at the moment, but occasionally, sporadically, some brown (old) blood. If nothing happens by Monday, the day before J~'s surgery, we will likely go for another ultrasound. I don't look forward to the dead baby ultrasound, but I would prefer to receive that verdict while J~ is available to hold my hand. And I'd rather have the information before wringing my hands in the hospital waiting room worrying about J~.

At this point, I am afraid of two things:

Miscarrying while he is in surgery (or recovery).

Having the pregnancy continue indefinitely, unhealthy.

Actually, make that three things:

What if something goes wrong in J~'s surgery?

Tuesday, July 17, 2007

Not Good News

I thought I'd be titling my next post, "Nausea" because that's what I've been feeling, and fighting, for the last few days, oppressive waves of it. Even toast and fruit were no match for it this morning. I thought I would be writing to solicit remedies. But I went to the bathroom after breakfast and found a silver-dollar-sized circle of blood in my underpants, plus more, a couple tablespoons worth, as soon as I sat down.

Adrenaline, it turns out, is the ultimate nausea cure.

I called J~, who'd finished his fifty-minute commute and was just settling into his work day. Ten minutes later, he was on his way home.

I called Dr. A~, who scheduled me for an ultrasound early this afternoon.

J~ drove, held my hand in the waiting room. I felt nauseous again, thanks to a lovely cocktail of nerves, hormones, and carsickness.

There was a heartbeat - erratic, slower (about a hundred beats per minute, as opposed to last week's healthy 150). A bad sign. The gestational sac was flattened, not as round as it had been, which is also a bad sign.

"Unfortunately, there's nothing we can do," Dr. A~ told us. It's a wait-and-see situation.

"Is there any chance..." J~ asked.

"Anything can happen," Dr. A~ replied. But he was not optimistic. He expects I'll miscarry in the next few days.

There's no getting around it. It looks like our baby is dying.

J~ cried in the parking lot. Cried again while he drove. (I had him pull over.)

I've cried my share as well. We've cried together. There will be more tears. Like I said at the top, this is not good news.

Friday, July 13, 2007

Powdered Ham

When I worked at the abortion clinic, people asked me if I ever felt angry or jealous, seeing all those fertile women giving up their pregnancies. I didn't. After all, if you're pregnant and you don't want to be, it sucks.

Before I'd call a client in for counseling, I reviewed her file, always glancing at the glossy little black and white ultrasound print-outs. Every now and then, I would see the ragged image of a miscarriage in the works. Once, the static starry-sky pattern of a molar pregnancy. In these cases, I'd read the nurse's notes and prepare to discuss them with the client. But usually, I found myself looking at the white shrimp-like blob of a growing fetus inside the dark abyss of an amniotic sac -- A healthy pregnancy. And that's when I'd feel it: a dull pang of longing.

I never got around to ultrasound with my second miscarriage, but I had two with the first. All you could see in the first was the little black hole, the sac in which a pregnancy would, presumably, grow. But it never happened. Several weeks later, the second confirmed what, by that time, I suspected, dreaded, knew: miscarriage was imminent.

Yesterday afternoon, I met J~ at the obstetrician's office. We sat holding hands in the waiting room, taking deep breaths, thumbing through a cooking magazine together. One of the recipes called for, of all things, "powdered ham." I wanted to throw up. Nerves? Pregnancy? I didn't know.

A nurse led us to the couch in the doctor's office. Assuming we wanted to check them out, she offered to tell us about the practice. "Actually," I told her, "the main reason we're here is to get the results from hCG tests." Surprised, she admitted the reports were not in my file. She left to call the lab about a fax. More deep breaths for J~ and I. She returned, reporting results were on the way. In the meantime, she launched into an introduction to the practice. beginning by listing numbers of doctors, midwives--

"I'm sorry," I interrupted, "I'm not able to concentrate on what you're saying." I briefly explained my history, my fears, my desire to hear the lab results first.

Finally, Dr. A~ appeared, and introduced himself. He sat, opened my file, clicked his pen to the ready position. "Let's see," he drawled, flipping pages, "I've got just a few questions for you."

"Can't you tell us the numbers first?" Meekly, I said this. Shaking.

"Well, okay," he shrugged, surprised, but, thankfully, understanding. He shuffled his papers, and then, before telling us, held up a warning hand and said, "I don't know."

Monday: 22153
Wednesday: 29156

My heart sank. I wasn't shaking anymore. I was numb. I looked at J~ and shook my head. Not good. Everything I'd read indicated that hCG levels should be doubling at least every three days. But at this rate, mine would take five.

The doctor was quick to say this doesn't mean much. Doubling rates slow, eventually. An ultrasound would give far more accurate information. "Your numbers are high enough that we should see a heartbeat."

"Can we do one today?" I was literally at the edge of my seat.

"Yes," Dr. A~ smiled. I sighed, relieved. He laughed. "Now can I ask you some questions?"

He clicked his pen again, collected some medical history, and then he, the nurse, J~, and I, trundled off down the hall.

There was a monitor mounted to the ceiling. In the dimly lit room, our eyes were glued to it well before the ultrasound wand was near my vagina. After some initial fumbling something came into view (Dr. A~ was like a nervous teenager with that thing, poking further and further from the mark -- I finally offered to put it in myself). Finally we saw it: the white shrimp-like blob of a fetus inside the dark abyss of an amniotic sac. A rapid flicker. "See that?" the doctor exclaimed. "Can't ask for better than that!" The nurse gasped (she later told us she'd had goosebumps, a chill up her spine). J~ drew in his breath, squeezed my hand. I corralled my tears, holding out for measurements. "How far along are you," Dr. A~ asked, clicking his mouse over the image, "six weeks, four days?"

I nodded.

"It measures exactly six weeks, four days."

Hello, waterworks.

I am sitting at the computer this morning in my bathrobe, with my Chinese herb tea and toasted rice bread, prepared by J~, and my very own collection of glossy black and white ultrasound print-outs, all contained in a cheesy little folder labeled, Baby's First Pictures.

Baby?

J~ and I went out to dinner to celebrate, couldn't stop smiling, laughing, shaking our heads, incredulous.

Baby??

I didn't sleep well last night, worrying over the hCG readings. But I found an article by Dr. Robert Warnock this morning that put me at ease, suggesting that once levels get beyond 6,000, it can take more than four days for them to double. "Once fetal activity has been detected by ultrasound," Warnock goes on to say, "the chance of miscarriage is usually less than 10%."



Holy powdered ham, people, I may be having a baby after all!

Wednesday, July 11, 2007

Blessing or Curse?

I've been nauseous today. It started with this morning's ritual cup of Chinese herbal tea, prescribed by my acupuncturist, prepared for me by J~. Usually I can drink this on an empty stomach with no problem at all. (Two weeks ago, when I still felt consistently pregnant, this was not always the case).

This morning, I felt queasy. I ignored it. Then I felt nauseous. I ignored that too. And then I felt sweaty and nauseous. Like maybe I was five minutes from on my knees over the toilet. I ate something and lay on the couch. And gradually, I felt better. And then, of course, I started to wonder.

I've had some queasiness all morning, but then also some crampiness, (though milder) and more brown-stained cervical mucus (though no darker, or more frequent than before).

Just when I thought I was resigned to it, finished (temporarily anyway) crying over another pregnancy loss, the tension is on again.

This afternoon's blood draw is done. Results tomorrow.

Friday, July 06, 2007

Surrender

Friday: very light cramps, yellow-stained cervical mucus.
Saturday: more cramps, light-brown-stained cervical mucus.
Today: cramps are steady and undeniable. Still no real bleeding, however. But this is how it went with my last miscarriage, too: cramps and intermittent staining for quite some time. The day I finally saw red blood, it was all over.

Also on Friday: J~'s second opinion from neurosurgeon number two: There is irreparable damage to the spinal cord. Without surgery, the next stage will be losing control of his limbs, and then paralysis. By Friday evening, J~ was experiencing tingling down his right arm, in his chin and the right side of his face.
Saturday: Though symptoms improved with a night's sleep, over the course of the day, the tingling returned. He tried calling the doc but the answering service will not put calls through unless they are from post-operative patients.
Today: Same thing.

These next two weeks, waiting for surgery and hoping nothing bad happens in the meantime, are going to be rough.

Monday (tomorrow): J~ will, hopefully, talk to the doctor about moving his surgery sooner. Meanwhile, I will have blood drawn to test my levels of HCG. At this stage in a pregnancy, HCG levels should be doubling every forty-eight hours. If they are not, miscarriage is imminent and unavoidable.
Wednesday: second blood draw.
Thursday afternoon: J~ and I meet at the OB's office, to hear the results.

I am not optimistic.

Wednesday, July 04, 2007

A Matter of Time

I give up. I can't sleep. It's 3:45 Wednesday morning and I am afraid it's all over. A week ago, I was queasy. Not consistently, but often. Every now and again, there would be a wave of true nausea. My breasts felt like they were going to pop. They're still sensitive, but it's not the same. And nausea? Even queasiness? Haven't felt it for days.

At twenty-five days past ovulation, it's way too soon for these symptoms to be fading. I hate to read into this in any way. But how can I not? I've been down this road before.

And that's not all.

For the past few weeks, J~ has had a strange weakness in his right arm. A trip to a chiropractor led to Xrays, an MRI, referral to a neurosurgeon.

The appointment was yesterday and it was not good. Even I, having never seen an MRI before in my life, knew this immediately when the black and white image of J~'s neck came up on Dr. S~'s computer screen.

The doctor pointed to the line between the vertebral bones. "This dark area is your spinal cord," he said, "and this white," he said, running his finger alongside the cord, "is your friend. It's the spinal fluid." The fluid cushions the cord inside the spinal column, inside the disks of bone. Here's the alarming part: the white area, halfway down J~'s neck, thins to nothing, then thickens again. The spinal cord itself is narrowed, pinched by ruptured vertebral disks. Dr. S~ pointed to the cord where the pinch was most severe. "See this white spot?" he said, "When we see this, if that was in your brain, we call it a stroke. It means there is already damage." Though recovery of the strength and mobility J~ had just three weeks ago is not guaranteed, Dr. S~ was adamant. "We need to fix this."

"Fix this" means surgery. It means shaving off the blown-out bone and adding artificial material, fusing three of J~'s vertebral disks with a metal plate. The spinal cord will be exposed, Dr. S~ told us, his face grave. "I'll be looking right at it. Everything that you imagine going wrong in this kind of situation, could go wrong. You could die. You could be paralyzed." Without the surgery, he went on to explain, J~ is at risk. Just one fall at home, just one rear-ending on the highway, and J~ could be paralyzed. "I've seen it happen."

On the wall of his office, there is a framed Connecticut Magazine. The cover story is something along the lines of, "Best Doctors in the state, as ranked by Doctors." Dr. S~ is listed, and this is reassuring, but not entirely. Similarly, it is reassuring, but not entirely, that he has done this procedure close to a thousand times without killing or paralyzing a one. "But it does happen," he made sure we understood. "In my case, maybe less than one in a thousand."

The surgery is scheduled for the soonest possible date: Friday, July 20th. If all goes well, J~ will miss work for about a month. In the meantime, he has appointments lined up: a second opinion, a third. A follow-up with the chiropractor, a meeting with the doc who will serve as his primary care provider while in the hospital. There is more, but we were reeling and I can't remember all of it. "Wear your seat belt," Dr. S~ admonished as we got up to leave. "Be careful."

Right now: J~ is sleeping in our bed. I can hear his breathing through the closed door of my office. Our neighbor's rooster is crowing, has been crowing for what seems an hour. Time is moving slowly. Outside my window, it is still dark. The rooster is impatient for morning, the Fourth of July, a holiday oasis in the midst of a very difficult week. Soon, the passage of time will again be brisk and leading unequivocally and without apology toward all things great and small. Although I am not sleeping, will likely not sleep again any time soon, at this moment, the night is a comfort.

Sunday, July 01, 2007

Battlefield

My sister-in-law, K~, called me in tears on Thursday. “I have some bad news,” she said. “I just had the second ultrasound…” The first ultrasound, performed at her request after several days of spotting, seemed promising. But a week later, “…It’s not growing.” Miscarriage is imminent.

We’ve been on the phone several times since, she and I, my brother and I, each of us crying in turn. It is a tough loss. It is always such a tough loss. But they are handling it well, and graciously transfer all their hope and good wishes to me.

How do I feel? The immediate sense, underneath my condolences and sadness for their loss, was exhilaration. I know this is twisted, but on some underground level, I felt that I had dodged a bullet. As if the fact that the ultimate four-star dedicated mother could go through this proved that my miscarriages don’t indicate maternal failing. As if because my sister-in-law is destined to miscarry, I am not. I know this is ludicrous. But pregnancy after loss feels something like a battle, and the battlefield brings up all kinds of twisted emotions. And like any battlefield adrenaline rush, it passed quickly, leaving fear and guilt and sadness in its wake.

I was going to tell you in this entry about the glorious triumph of the positive pregnancy test…

(J~ and I, squeezed together in the tiny downstairs bathroom, saying, “Is that a line? It looks like a line. I think that’s a line!” and falling into each other’s arms, laughing. B~ the next morning, in the larger, upstairs bathroom, where we intercepted him to tell him the news. “Cool,” he said, turning to the mirror. “Wow, my hair is really getting long.” He’s underwhelmed, I muttered to J~, and B~ said, “It’s not that. I just expected this at some point.” I reminded him of my history, not to get his hopes up. And then he came to kiss me, three times on alternating cheeks.)

…All of this feels like ancient history now.

There have been moments when I’ve felt surges of confidence, allowed myself to embrace them, to tell myself, This is going to work out. There will be a baby this time. But I’ve noticed that the counter-force always appears, the equally powerful wave of doubt and dread. It seems this opposite certainty always comes along to provide balance, to remind me that actually, I don’t know. I won’t know. And even if I do make it through the first trimester, still something could go wrong. And even if I have a healthy birth, there will be new challenges to face, not the least of which might be keeping the child alive. The upshot is this: I am pregnant right now. That is amazing. That is all I know.