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.

Little Girl Gone

We got our genetic test results back today. The baby I miscarried was a genetically normal girl.

The nurse I talked to said that there is a very small chance that my DNA could have contaminated the results, but she thinks it’s highly unlikely in this case. She explained why, but I was too out of it to really pay attention.

A part of me wished the baby had been genetically abnormal because then at least I would have known beyond a shadow of a doubt that it was not meant to be.

But she was normal. She should have had a chance. Instead she is just gone.

I want to scream “Why?” at the Universe. I want to kick down trees and bust through clouds and pound my hands on the street. I want to beg and barter. I want, more than anything, for this not to be true. But it is true. We had a little girl. She was normal, she was alive. And now she is gone.

Her name is Anna Adele Best.

Anna is after my paternal grandmother and Tim’s maternal grandmother. Adele is the name of Tim’s paternal grandmother. All those grandmas are in heaven now, if such a place exists, so hopefully they can keep our Anna close and tell her how much she is loved.

The fact that this baby was a girl is hitting me just as hard as the fact that she was genetically normal. I know just what it’s like to love a little girl and it’s pretty much the best thing ever. I know exactly what I’m missing.

It makes me sad for Lettie, too. She could have had sister to share life with, a best friend, a conspirator.

My Anna. Gone from us too soon, but loved beyond measure.

I love you to the sky and back, sweet girl. I hope to someday hold you on the other side.

What’s Next: Doctor’s Appointment Update

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Disclaimer: This is fairly boring post that you may want to skip if you’re not interested in the details of IVF or miscarriage.

We had our what-the-f*ck-happened appointment with our doctor on Monday. I had a two-page list of questions prepared, starting with the IVF cycle and ending with the miscarriage. Here’s what we learned:

I did not respond to the IVF meds as well as my doctor thought I would. She initially started me out with what  was a higher-than-normal dose because she was worried there might be some after-effects of the cyst. She said she was prepared to lower the dose, but instead ended up having to up the dose. She said this could indicate that I had lower ovarian reserve, despite the fact that my FSH and AMH (two tests they use to predict ovarian reserve) were good. I guess ovarian reserve is a big predictor of IVF success. The more you have, the more likely you’ll be successful. And the opposite holds true for low ovarian reserve — less chance of success. So, yeah, great, possible secret low ovarian reserve. That’s definitely what I wanted to hear. I’m not even sure what to do with that one. I feel a little blindsided by it. I don’t understand why my tests would be normal, yet my ovarian reserve is still possibly jacked.

If we do a fresh cycle going forward, she would continue with the same protocol as the first time (estrogen priming with no birth control pills), but start out with the higher dose of meds than I ended up with last time.

As far as the recurrent miscarriage tests go, the ones that came back so far were normal, save for one of the blood clotting ones, which was slightly elevated. She said that could just be attributed to still being pregnant, though, so they will retest me once my hcg drops to zero. The genetic karyotyping that Tim and I had done is not back yet. There are also several other tests that she wants to do, but she again wants to wait until my hcg is at zero.

Apparently my last hysteroscopy showed a slight heart-shaped uterus and a slight septum. Either of these things could have contributed to the eccentric embryo implantation, which could have contributed to the miscarriage. She said that the hysteroscopy findings previously did not worry her because I’ve had a successful pregnancy in the past. But now, based on the fact that I’ve had the wacky implantation, she may recommend surgery to get the septum removed. Sweet, another possible procedure. She’s going to see what the results are of my next hysteroscopy are before she makes that decision.

I had a D & C on Thursday (more on that in another post) and they are going to genetic test the “products of conception.” Lovely term, right? Apparently, it isn’t a sure thing on whether they can get reliable test results or not (I’m not clear on why), but hopefully we’ll get some more information.

Because I’ve had two losses, my doctor suggested that we pursue genetic testing if we do another fresh cycle. Apparently, if there are no other underlying issues, blastocysts that are genetically normal have a 70% chance of resulting in pregnancy.

We basically have a few options going forward:

1) Use the frozen embryo we have and don’t genetic test it.

2) Use the frozen embryo we have an attempt to genetic test it. If it’s already hatched when it thaws, then it can’t be tested.

2) Do a fresh cycle and genetic test the embryos we get during that. We can also defrost the frozen one at that time and test it with the others, if it can be tested.

Right now we are leaning towards option three, a fresh cycle. I’m not sure what we’ll do with the frozen one yet — that’s what we can’t figure out. I don’t want to end up doing something that will waste it somehow. I would hate to thaw it, find out it can’t be tested and then have to re-freeze it and risk damaging it. It very well could be totally normal. It could be our take-home baby, but I’d like to have some backup in case it isn’t. There are just so many unknowns here, it’s hard to know what to do.

I think the results of our recurrent miscarriage panel and whatever we learn genetically about the baby that I miscarried will help guide our decision as well. It could be well over a month until all of that comes back, so for now it’s all speculation.

Regardless of what we decide, I’m benched from starting another cycle, be it frozen or fresh, until at least mid March. I have to wait for my first period so my lining can repair itself after the D & C  and then I have to get another hysteroscopy. So I won’t be able to start another cycle until my second period after the D & C. Plus, who knows how long this potential uterine septum surgery could delay things

And that, my friends, is what’s getting to me the most about this whole experience: waiting, waiting and more effing waiting. I just want to be moving forward. I feel like time is one thing that I don’t have the luxury of right now.

At least two more months for another chance at getting pregnant. That’s just for another chance! And if that chance doesn’t work, more waiting. And even if it does work, it doesn’t mean I’ll have a healthy baby in nine months. I know that, in the end, this period of infertility will just be a few years out of my entire lifetime, but right now I’m struggling to see anything beyond the waiting, uncertainty and heartache.

In Loss Limbo

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It is New Year’s Eve, a time of new beginnings. Yet here I am, in the middle of a long, slow ending. As you know, my baby has died. There is no longer a heartbeat. On Monday, the ultrasound showed that the embryo had “deteriorated.” All signs point to goodbye, so long, see you on the other side. But my body won’t let go.

I’ve had no bleeding since last Wednesday night. As of Monday, my hcg was still rising and my progesterone was sky high.

On the one hand, I am grateful to my body for holding on. I’m grateful that it wants to fight for this. I truly am. Body, you are a rock star. But I also just want this part, the physical part, to be over.

There are three options when you have a miscarriage: wait for things to happen naturally, take a pill called Cytotec to induce contractions, or get a surgical procedure called a D & C or D & E. I had a D & C last time. It was completely fine — some cramping, some spotting, that’s it. This time, I am worried about about the risks of the procedure, which include scarring to the uterus. I really don’t need another thing hampering my fertility. And the miscarriage pill? No way, Jose. That scares me. I’ve read many horror stories, some of which say it’s like labor or the worst pain ever felt. I’ll save labor for live babies, thank you very much. And why, when I’m already in so much emotional pain, would I want to add excruciating physical pain to the mix?

So really, what I want is for this to happen naturally. But I also don’t want to wait forever. Carrying around a dead baby is, well, very sad. To this end, I’ve scheduled a D & C for Tuesday. Due to my hemming and hawing, and my clinic’s holiday schedule, they really couldn’t get me in any earlier. I am fine with that. It gives my body almost two weeks from finding out about the loss to do its thing. If there are no signs of letting go by then, I think I will just need to move on at that point.

My doctor has been on vacation since Christmas Eve. She returns on January 5th and we have an appointment to talk to her that day. I’ll ask her about the risks of the D & C then. If she seems concerned, I’ll suck it up and take the freaking Cytotec.

Fun fact: if I miscarry tomorrow, it will end up being a grand tour. Get pregnant on Thanksgiving, find out the baby is gone on Christmas and miscarry on New Year’s Day. A holiday trifecta, people! And yes, I am kind of laughing as I write this part, because it’s both funny and not funny at all.

While I wait for all of this to go down, I’ve been attempting to eat away my problems. I’ve thrown my no-gluten, no-dairy rule to the wind. I’d really like to be drinking my face off as well, but I’m still feeling nauseous, so alcohol isn’t really in the cards. After almost a week of this, I am, not shockingly, feeling physically awful, so it’s probably time to get back on the horse. Fiiiiine.

What do I long for this coming year?

Hope.

That’s it. I’ll keep it simple. I want this to be a year filled with hope.

And I do feel hope. Even now. Right in the center of my aching heart, I feel it. I now know that IVF can work for us. That’s huge. Sure, IVF contributed to the embryo implanting all askew this time, possibly causing the miscarriage. But that doesn’t mean it will happen like that the next time. Nothing is certain, which means anything is possible.

So here we go: 2015. May it be a hopeful new year. For all of us.

Love in the Time of Miscarriage

It’s 8:24 a.m. Tim and I sit in our car in the hospital parking garage. Outside, the September sky is a cloudless blue. The temperature is mild. It’s a perfect day in Philadelphia.

The garage is warm and dirty and dark. There are tire marks on every wall. Even still, it’s better than out there, with all its sun and all its blue. It’s better than watching people walk to work like they do every day, as if this day is no different than any other.

There is no spoken agreement to stay in the car, but neither of us makes a move. We’re listening to a country cover of Coldplay’s “Fix You.” I watch the dial on the dash clock. Even though I do not want to get where I’m going, the thought of being late still makes me anxious.

After all, I have places to be. In six minutes, I’m due to check in for a D & C procedure.

Tim sits at one end of the car and I sit at the other, my shoulder and face pressed against the glass. Through the speaker, Carrie Underwood croons.

Tears stream down your face
When you lose something you cannot replace

I move away from the window. Tim puts his arm around me and I lean my head on his shoulder, like we are two kids in love at the movie theater. Except this is not a movie, and if it was, no one would ever want to watch it. I realize I’m crying, I think for the first time since we found out our baby would no longer grow. I can’t see or hear Tim, but I know he’s crying, too. This is it: goodbye. Once we leave the car, there’s no going back.

And right there, in the saddest moment we’ve shared, I feel it—a fluttery brush of sweetness, a tiny coil of peace. We are going, and we don’t like it, but we are going together.

So we go. The song ends and we step out of the car. The humid air rises around us. The elevator sounds its oblivious chime. Tim is holding my hand, and I’m thinking, Oh, how I love you—deeper, wider, still.

I Just Starred In A Carrie Remake

If you read my last post, you know that I was wondering if I might miscarry on my own before my scheduled D & C.

Yeah. That happened. And people, it was not pretty. It was like I was starring in my own personal horror movie…and I was not one of the lucky ones who survived.

I started miscarrying in one of the stalls in the bathroom at work. That was obviously awesome. As I was losing ridiculous amounts of blood and God knows what else, I could hear the click-clack of heels on the lobby floor and the sounds of women talking about absolutely nothing.

I texted Tim and he hopped in a cab to pick me up. When we got home, it got worse. I started feeling lightheaded, so I called the on-call midwife and she told us to head to the ER.

By the time I actually got into the ER triage, the front and back of my shorts, and the bottom of my shirt were soaked in blood. My shirt? Seriously? As we walked in the nurse said, “What are you here for?” Then she took one good look at me and said, “Oh.”

All told, we were in the ER for seven hours. They did an ultrasound at some point, which revealed that the miscarriage was incomplete. They suggested I keep my scheduled D & C appointment the next morning. I was crushed. After all that, I still needed surgery? No. Just no. Honestly, I think I ended up completing the miscarriage after I got home from the ER, but I got the procedure anyway because I wanted to be sure.

The D & C went smoothly. That was a week ago. Sometime in that week, I noticed my perspective on the whole I-can’t-believe-that-happened-and-then-I-still-needed-surgery-holy-shit thing was changing. Because here’s the deal: when I first found out that my baby had died and my body didn’t realize it for weeks, I felt duped. I felt like I couldn’t trust my body. How could the life inside of me have passed on without my body recognizing it? I remember thinking I just want to be able to trust my body.

I think the fact that I ended up miscarrying on my own was my body’s way of saying, Hey dude, you can trust me. I asked and my body listened. I’m taking that as a win. And yeah, I still needed the D & C. But you know what? That’s ok, too. It was closure. I don’t ever have to wonder if there was something left over that might have caused an infection down the line.

I’m not going to lie: I’m devastated. I wish none of this happened. But it did. And I made it through a week. If I made it through one week, I can make it through another.

Now my heartbroken mind and my trustworthy body are going the only place we can go: onward.

Saying Goodbye

I got word on Monday that my pregnancy was officially non-viable. Much to my dismay, they couldn’t schedule a D & C procedure until Friday. I started spotting yesterday, though, so perhaps I will miscarry naturally before the procedure. Or maybe not. More waiting.

While I wait, I’ve been eating a lot of Doritos. You know, grazing from a family size bag that has been open since Lettie’s birthday party in July. Amazingly, they are still not stale! The miracle of preservatives, my friends. Two nights ago I had Doritos and a half a piece of chicken for dinner. Last night, Doritos and one sliced-up bell pepper. Tonight? The possibilities are endless. A Dorito sandwich, perhaps?

Also while waiting, I named the baby. Tim and I named him Gabriel, which means “God’s able-bodied one” or “God is my strength.” Mostly, we just like the name, but the meaning is lovely. It’s a nice thought to picture baby Gabriel chilling with the Grand Creator, or maybe floating like a light through the universe, making it a brighter place. Of course we can’t say for sure if the baby was a boy, but I believe that it was.

I’ll likely never know why this happened, at least not in this lifetime. I will make peace with that at some point.

But not right now. Right now the only thing to do is to go through it.