Hello Darkness, My Old Friend

Let me start out by saying that baby is fine.

But we had a scare. And I have anxiety. Not a good combo.

I’ve talked on here before about my tendency to fret and worry, mostly in a jokey way, but I’m not sure if I’ve ever come right out and said that I have legit clinically diagnosed anxiety. It’s a disease just like infertility. And also like infertility, it’s not really something that’s readily understood or discussed in society. You can’t make it go away by positive thinking or relaxing. You can’t shut it off. You can do cognitive behavioral therapy, traditional talk therapy or SSRI meds, and all of those things help (although I personally haven’t tried meds), but they’re not a cure. I am currently in therapy. My therapist is good, but I only see her once a week. That leaves six other days for my mind to spin into circles.

Overall I’ve kept my anxiety fairly in check this pregnancy. I for sure had some very anxious bouts. The first trimester in particular was super scary, as was Christmastime. I’ve been keeping it together, though…for the most part.

But now? Sh*t has gone off the rails. Ever since I entered the third trimester, my anxiety has been building. My antiphospholipid antibody syndrome puts the baby at higher risk for stillbirth, so naturally I’ve been obsessing about stillbirth. Is this a productive or beneficial thing to do? Nope. Rationally, I totally know this, but anxiety doesn’t play nice with rationality. It actually beats the crap out of rationality on a regular basis.

Things kind of reached a peak over the last few days. On Tuesday evening I noticed that baby wasn’t moving as much as she normally does, so I did a kick count. A kick count is where you count the baby’s movements—you’re supposed to count 10 movements in two hours. She did her required ten movements in a pretty short span of time, so I stopped worrying.

Then later that night I woke up around 3:45 am. Baby usually wakes up every time I wake up in the night, without fail. The kid likes to party all night long already. But she didn’t wake up this time. I gave her about 20 minutes to start moving and shaking. Nothing. I ate a banana and waited. Nothing. I drank some orange juice. By this time I was wide awake, but baby wasn’t. She did eventually bust out ten movements after the OJ, but it took her the full two hours. Usually it takes her, like, five minutes. I got out of bed and was about to go into Labor & Delivery to get her checked out when Tim suggested I try drinking a Coke as a last ditch effort. I drank a Coke and it worked. She did ten kicks in about two minutes. I was semi freaked out, but figured baby was fine.

That brings us to this morning and my appointment with maternal fetal medicine. I have weekly non-stress tests now, and from 36 weeks on I’ll have them twice a week. A non-stress test is basically where you chill in a lounge chair and a nurse hooks the baby up to monitors. They are looking for baby’s heart rate to accelerate three times in 20 minutes. If that happens, they are assured that all is well. I was figuring the non-stress test would be a breeze like it was the previous week, and that it would provide me with some reassurance.

Only, the baby didn’t pass the test. The nurse told me that the baby did have some accelerations, but they weren’t fast enough. She then sent me for a biophysical profile. This is an ultrasound where they look for three things within 30 minutes:

  1. Baby needs to be seen practice breathing for at least 30 seconds
  2. Amniotic fluid levels must be adequate.
  3. Baby has to move her core back and forth three times, and she also has to show muscle tone, which means things like opening and closing her hand or flexing her leg.

She aced the practice breathing. She also had good amniotic fluid levels. But she wasn’t moving. It took that little runt almost the full 30 minutes to do her required movements. She did pass the test, but only in the nick of time. The nurse assured me that she was fine. She said she was the most conservative nurse there, and that she always errs on the cautious side, but even she felt confident baby girl was good.

So baby is ok. But I am not. I really am not.

I’m 33 weeks today, and my OB has already talked about inducing me around 39 weeks (common practice with antiphospholipid antibody syndrome), so there is an end in site. But I don’t know how I’m going to make it through the next six weeks. I’m not trying to be dramatic by saying that—I really feel like I’m losing it a little. I feel completely overwhelmed with fear and anxiety. I’ve talked to my OB about these feelings. She doesn’t want me to take any anxiety medications because I’m already on so many other meds this pregnancy. She suggested therapy, which I am already doing. Basically the only course of action is to wait it out. I want this baby to be safe and healthy in my arms so badly, but right now that seems so far away.

Letter To My Littlest Love: Acorns, Stars & Other Things

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Dear Little Acorn,

You have many nicknames already, most of them generated by your sister. At first, you were Staircase Ball-Jar, followed by Cupcake Christmas Tree. Your current name du jour is Rocky Stone.

But there’s one nickname that belongs to you and I alone: Little Acorn. There is a story there, of course.

The day before I found out I was pregnant with you, your dad, sister and I were wandering through a boutique near our house. Hanging on the wall was a bright green onesie. I’m partial to crazy, happy colors, so it immediately caught my eye. On the onesie was an illustration of an acorn, and beneath it the words, “I will be mighty.”

Truth be told, I’m a little slow sometimes, so I didn’t immediately get it. “Wait. Why does it say ‘I will be mighty’ with a picture of an acorn?” I asked your dad.

“You know,” he said, “because an acorn starts out tiny and then grows into a big, strong tree.”

Oh. Oh. My heart started racing right there in that store. Because at that moment I knew: that onesie was for you. My little fighter embryo, destined to grow into a mighty oak.

I didn’t buy it, though. After all, I wasn’t even sure I was pregnant. I hoped, oh God did I hope, but I didn’t know. But I promised myself that I would come back and buy it for you if I was indeed pregnant.

Even though I found out the next day that you had decided to stick around, I didn’t go back. I was too scared. It took me almost six weeks to go back and purchase that tiny green onesie. And even then, when I was asking the sales associate about sizing, I didn’t tell her it was for my baby. I pretended it was for another baby, maybe a friend’s baby, or a random nebulous baby belonging to no one.

You see, I was worried sick. And if I’m honest, I still am, most days. (It’s no secret that your mom is a first class worrier. If you ever want to go skydiving or something, talk to your dad.) I feared that my instinct was wrong and that you weren’t a fighter after all, that you weren’t here to stay. That you weren’t mine to keep, not this time.

But you have proved me wrong time and time again. Out of dozens of embryos, you’re the only one that decided my inhospitable body was a fine place to hang out for a while. So far you are surviving and thriving. And just now you kicked me, as if to say, “That’s right, mom. Here I am!”

Yesterday, your sister and I watched a planetarium show. We learned lots of cool things. One of Jupiter’s moons contains frozen lakes with liquid water churning underneath. The hottest stars are blue. If you get lost on a clear night, you can always find your way home by the Big Dipper—it points right to Polaris, the North Star. The sun is so big that it could hold 1.3 million earths.

And even beyond our sun and our solar system, there are infinite stars and planets. An ever-expanding universe—over 10 billion light years that we will never discover.

It seems hard to believe, then, that with all of those things out there bigger and more awesome than we can even imagine, that something so small—an embryo, an acorn, a baby—could even matter.

But you, mighty one, are our whole world.

We are all counting down the days until we can hold you, kiss your new, soft skin, and see the stars in your eyes.

Love,
Mom

Does My Loss Count?

I’ve been thinking about this a lot lately. I’m not sure what I want to say about it, but I feel like I have some kinks to work out in my head.

The question that’s been on my mind: Was the loss of Baby B not a real loss?

It doesn’t seem to count as a loss in the medical community. When I first met with the maternal fetal medicine doctor, he told me that I technically don’t have enough losses for him to officially say I have antiphospholipid antibody syndrome. “You need three early losses to qualify,” he said. I didn’t say anything at the time because I suck at saying things in the moment, but now I wish I would have asked him, “What about this baby’s twin? Why doesn’t that count as a loss to you? Is it because I had no bleeding? No D & C? Is it because half of the pregnancy continued to grow?”

It doesn’t seem to count in the general population either (present company excluded, of course). I’ve mentioned to several friends recently that this pregnancy started out as twins, but one didn’t make it. And you know what? Not one person said they were sorry to hear that. There was no acknowledgement whatsoever. Doesn’t that seem kind of…odd? On the one hand, I completely get it. I have a healthy pregnancy, which is freaking amazing, and I’m sure these friends just wanted to focus on that. I understand, I really do. Their responses, or lack thereof, made me feel weird, though.

And sometimes, the loss doesn’t even seem to count in my own head. For instance, I haven’t named Baby B yet. I named Anna and Gabriel right away, but Baby B remains without a moniker. I suspect this is in part because Baby B is inextricably connected to Baby A, and it doesn’t feel quite right to name B before the birth of A.

But still, I wonder about my lack of interest in choosing a name.

I’ve also spent far less time thinking about this loss than my last two losses. Practically speaking, I think it needs to be that way, at least for now. I have a little girl growing inside of me that requires my love, care and hope, and it doesn’t feel right to focus my energy on the pregnancy’s darker beginnings.

But still, I wonder, am I a bad mother for not grieving for Baby B more?

I feel confused about all of this. Because when it comes down to it, Baby B was alive. He or she had a beating heart. He or she was loved. And most importantly, I truly believe he or she helped her sister to grow and thrive.

And that, in my heart at least, counts for a lot.

28 Weeks And We Are Still Ok

I’m 28 weeks. Which means I’m in the third trimester. Say what? For some reason it really hit me today that, holy crap, I’m in the third trimester. And then I started crying. Because how did that happen? How did I get this far? I’ve said this every step of the way, but I never thought I’d be here. It’s truly humbling. Currently, the baby is kicking my bladder and I’ve never been so happy to have to pee every five seconds in my entire life!

I’m not going to lie and say my head is screwed on straight and I’m the very picture of calm. I’m still scared, I’m still anxious, but both baby and I are doing ok. We had a 3D ultrasound last Saturday and we saw the little nugget yawning and smiling and sticking her fingers in front of her face. I won’t post any pictures here because I don’t want them to upset anyone who’s having a bad day in Infertility Land. But if you actually want to see alien baby shots of the inside of my uterus, send me an email at theskyandbackblog@gmail.com and I’ll pass some along.

On Monday we had a growth scan and the doctor told us that baby was growing on target. Then on Wednesday I found out that I don’t have gestational diabetes! I was certain I would have it because prednisone raises your risk, but I passed the test with flying colors. In my pregnancy with Lettie I was borderline, so I had to watch my sugar. This time, though, it’s Coke Classic and Sour Patch Kids and gluten free Oreos all the way! Actually, I probably should watch my sugar anyway because I’m still gaining weight like an ox, but….nah. Maybe tomorrow.

So I’m hoping that even though this pregnancy started out in a dramatic fashion, the last third will go smoothly. Please, please, pleeeease.

I don’t have much else to report. Tim is painting the nursery today, which freaks me out, but like we need to do it at some point. We’re going with mint green. I always laugh as I write these update posts because they are so blah. Like you guys care that we’re painting our walls mint green!

I took this week off and we’ve been doing things around the house (today guys are here jack-hammering our basement). But we did take one overnight trip to the Pocono Mountains to visit Great Wolf Lodge. This is basically a hotel with a giant water park inside of it. It was completely insane (think Lord of the Flies), but fun, and most importantly Lettie had a blast. She said it was “a million fun.” I’ll leave you with a few pictures from our trip.

Happy Friday! Love you guys!

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The Things She Carried

[inspired by Tim O’Brien’s novel, The Things They Carried]

She carried 758 needles, 170 suppositories of the vaginal variety, and hundreds of blood draws—she was told she had good veins, like that was some kind of prize to win. She was weirdly proud of her awesome veins, because in this game of carrying and dropping, losing and winning, there’s not much else to be proud of.

She carried 63 ultrasounds, some of them a routine check for follicles, some looking in vain for beating hearts, some checking to make sure “the products of conception” no longer existed inside of her.

She carried names of drugs she could barely pronounce—Menopur, Follistim, Ovidrel, Ganirelix, Intralipids, Lovenox, Prednisone.

She carried four IUIs, three IVFs, 66 follicles, 33 eggs and 20 embryos. Some of these embryos were placed back inside of her, and some never grew beyond a handful of cells. All were loved.

She carried lesions on her ovaries, cervix, uterus and bladder. She carried a blood clotting disorder called antiphospholipid antibody syndrome. She carried overactive natural killer cells, which weren’t really killing much except teeny-tiny embryos too little to fight for themselves.

She carried one laparoscopy attempt. One actual laparoscopy. Three egg retrievals. Two transfers. Two D & Cs.

She carried 1,938 miles of travel—from the house to the fertility clinic; from the clinic to work; from Philadelphia to Manhattan for surgery; from Philadelphia to Woodbury to visit what she hoped would be a miracle doctor; from Philadelphia to Woodstock to spend the day with a fertility visionary. She carried $726 in parking garage fees, and even one parking garage accident.

She carried Please Gods and plea bargains. She carried what-ifs and what-will-I-do-nows.

She carried special diets—no gluten, no dairy, no sugar, no air.

She carried the love of a good man, but she carried it clumsily and sometimes carelessly. She lashed out. She yelled. “Why can’t you carry any of this for me?” she wanted to know. There was no good answer to that question—he knew it and she knew it, and at the end of the day she was lucky to still be holding his heart.

She carried the memory of lost babies—three at last count. First was Gabriel. She lost him on the bathroom floor at work, and by the time she got to the hospital she was so bloody it looked like she was starring in a Carrie remake. Then there was Anna, who was confirmed genetically normal and therefore should have lived, but didn’t. Anna, who said au revoir to the world on Christmas day, but who would never open a single present. Finally, there was Baby B, a loss too new to even get a name.

She carried a persistence that even she admitted was insane. She carried advice from relatives, friends, acquaintances, the checkout lady at Target, wondering why she was doing this to herself, why she didn’t just give up. Stop this nonsense. Be happy for what you have. Halt. Cease and desist before you ruin yourself, your job, your marriage. And she did want to stop, she did. But she needed to try one last time. One more needle, one more blood draw, one more doctor. One more.

And now.

Now she carries a baby inside of her, a little girl, no bigger than a winter squash. She feels her kicks, taps and nudges, and they feel like hope. She still carries the what-ifs—so many what-ifs—but now she carries something else as well—trust. Trust that this is the soul she is meant to meet. She sings to her baby every night, hands on her belly, heart wide open as a summer sky: ‘twas grace that brought you safe thus far, and grace will lead you home.

Today We Celebrate

BigSis

Today I am 20 weeks pregnant. Halfway home.

Boy, that time sure didn’t fly.

Needless to say, I’m happy to be here, waving goodbye to the first half of my pregnancy.

Yesterday I had my much-dreaded anatomy scan. I had tears in my eyes on the way up the elevator. In the waiting room, I felt sick to my stomach.

But you know what?

Once I finally got in and got scanned, that baby looked perfect. Absolutely perfect. He or she was quite cooperative, too — turning just so for its measurements and letting the tech get a good look between its legs. The tech wrote down the gender and sealed it in an envelope. We’ll find out with our friends on Sunday if we’re having a boy or a girl. I will, of course, let you guys know.

The tech didn’t give us much during the ultrasound, but the doctor came in afterwards and told us everything looked good. I asked him about downs and trisomy 13 and 18. He said the scan doesn’t always detect downs (about 50% of the time), but that it almost always detects trisomy 13 and 18. “These things are not subtle,” he said. So we are hopefully in the clear from the big, bad guys at least.

At the end of that conversation the doctor looked at me and said, “That kid is fine. I don’t want you to worry about this. I want you to go home and have a healthy pregnancy.”

You can’t get much more reassurance than a high risk OB telling you your kid is fine.

I asked the doctor about non-stress tests because my regular OB mentioned that I might need them later on in the pregnancy. He said I didn’t technically need them, but it seemed a little strange to him to have me so closely monitored in the first half of the pregnancy and then nothing in the second. Then he said, “Non-stress tests are also good for our anxious patients. They put their minds at ease.”

Boom. Nail on the head, buddy.

I told him that I definitely qualified as an anxious patient, so we agreed that I would come back at 32 weeks for a growth scan and my first non-stress test. He also told me that he was totally fine with me coming in for a scan before then, too, if I felt anxious and wanted reassurance. How cool is that?

Later that night, we told Lettie she was going to be a big sister. She was completely underwhelmed. I pretty much expected that. She’s jazzed about the gender reveal party this weekend, though. Girlfriend loves her a good party.

And that’s about all I got. I just wanted to share the good news. Of course, scary things could still happen and my anxiety is not going away any time soon, but I might let it hibernate a little. For five minutes at least.

Because it finally — finally — feels like it’s time to celebrate.

Huzzah!