Just for the record

I don't want a replacement baby.

I don't.

I think the absolute least helpful thing in my grieving process is to be told that I'm young enough to have another baby, that I can hold or visit some other newborn, or that there's adoption, surrogacy, and fertility treatments.

I am fully aware, and need no further reminding, of my chances of future motherhood. Every pregnancy has a 20% chance of miscarriage, more so earlier on. There's a 10% chance of another ectopic, and an 8% chance of tertiary miscarriage. My chances of having another heterotopic miscarriage, like the one I just had, are 1 in 30,000 without fertility methods. All together, there's a good 18% likelihood, even with my terrible, approximate, never-took-stats math skills that I'll never have a living, breathing child.

I've had three dead babies. I think that's enough for now, don't you? Enough to not mention trying to conceive, or meeting your unborn children for the "healing that only small children can bring".
Enough to deal with.
Even if I wanted to think about it right now (which I don't, in case you forgot from above) it isn't medically advisable to try so soon. I just spent a month bleeding vaginally and internally, had surgery, and finished finals. There's no way I could physically support trying again to any success.

I appreciate that no one "means it like that". It's all goodhearted and whatnot. Just trying to comfort, and so forth. But miscarriage occurs at a 1 in 5 rate any way, so you're bound to run into someone else going through at least generally what I've been through this month. Writing all of these numbers down, finalizing what they really mean, is worth it to me if I can prevent someone else from having to deal with the insensitive and rude comments that just flood the gates.

If I'd had my appendix or gallbladder out, no one would dare look me in the eye and ask me when my husband and I plan to have sex for the intent of babies.

This is no different, only, they took my uterine tube out. It's surgery. It's a rough recovery, even if I hadn't had to wait until I'd been bleeding internally for three days to have a surgical consult. There's grief involved, and I think it's appropriate to try to deal with that. Just not with replacement babies.

So please
-unless I've specifically brought up the subject, or you're my gynecologist-
Stop asking about my sex life.

hospital visits

I had another baby, but I didn't know it. What kind of mother is unaware of a second tiny life, when she's so attuned to the first two babies she's lost? Me, I guess. And in my defense, this year has been the most awful emotional roller coaster I've ever been on. Numbing to sensation, to more loss.

Thursday before last, I thought I had food poisoning. The pain swelled and developed beyond food poisoning, beyond the flu, beyond even what I can bear. It turned into that praying sort of pain, where the only thing that's thinkable is to recite the Lord's prayer, over and over with each wave, crying and hoping that the sensation will recede soon. The following Saturday I went back into the clinic, and they were convinced that this was no food poisoning. Another pelvic exam, abdominal exam, and two blood draws later we were back to waiting, but under strict instruction to go to the emergency room if the pain got worse (dear lord, how could it?) or if I had a fever or if I started throwing up. I spent the night fitfully dreaming and waking, thinking about going to the ER but trying to wait for my husband to get off work, trying to make it through.
Sunday morning the pain worsened and the nausea returned and to the ER I went. The nurse there was unconvinced that there was anything they could do.

She looked at me and said "What do you want us to do?"
I replied "My primary care physician told me to come to you if things got worse. I want to know what's wrong with me."

She hemmed and hawed and basically gave me the impression that I was wasting their time, and that I should have stayed home. They redrew the blood tests. The doctor ignored my careful notes and memory, pressing hard and bringing me to tears through his abdominal exam. They did not order a pelvic exam or any imaging. They gave me pain killers and sent me home.
They told me to come back if things got worse.
I'd already gone to them when things got worse, and they did nothing.

I spent the rest of Sunday popping pills, thinking I was a cloud and crying over my distended, painful stomach.

On Monday morning, I called an OB/GYN surgeon that one of my professors had recommended, and they fit me in within an hour. I didn't take any pain medicine so that they would have an accurate exam. My mom drove me to my appointment, so that my poor working husband could sleep.  The surgeon did a pelvic exam and a quick vaginal ultrasound, and found blood in my abdomen. She thought it was an ectopic pregnancy, and was ordering in the methotrexate (an anti-cancer drug that is used to dissolve ectopic babies) protocol, but sent me to a different imaging specialist in north east p-town to confirm and visualize this second, unknown baby.  I took the 1000 mg of vicodin as I left her office, under her adorable and comforting supervision. Time slowed down and blurred as I saw the flowers bloom and cried over directions and worried about parking. Mom prayed and made it over 3 lanes to get off highway 405 at the right exit. I shuffled inside the imaging place and began to fill out more paperwork.

I saw the clouds edged in silver lightening, and then the imaging receptionist called me to come to the back. Missing my clothes, but clad in a cozy armor of gowns, I had another pelvic ultrasound and another vaginal ultrasound. The pressure made me cry. My mom held my hand , ducking under my supportive and validating technician. When I said "It hurts!" she didn't say ok. she didn't ignore me. She just said a simple "yes" and backed off. Even through the pain, I appreciated her validation so much. She showed me, on the screen, where my stomach was full of blood, and my scarred and distended ovarian tube.

The ultrasound tech called my surgeon back, and my surgeon asked me to return to her office instead of getting the blood work she has also asked me to get on my around-town mission for facts.

The parking garage was two blocks from her office, but my mom helped me walk there. I was so tired, and it hurt, and so spacey from the pain medicine. I was sitting in the waiting room on an overstuffed red chair with no arms. My surgeon came out to get me, and mom and I walked back to her office. I sat again, this time on an office chair made of supporting bungie ropes. The day started to blur together, as she had me sign surgical consent forms and told me which hospital to go to. Her office was disorganized, but her tan corduroy skirt was immaculate. She talked so quickly to put me at ease, but said she might have to take the whole tube out. She talked me through the whole surgery, and then sent me on my way.

Now, back in mom's Ford Escape, sitting on the third floor of the parking garage, we began to call family as I gave my mom directions to the hospital, the hospital that had discharged me the day before with my belly full of blood and pain, the hospital that my husband works at. We walked in the main entrance, and finally got a wheel chair so that I could sit. My head was spinning and so far away. Back to surgical admitting, where they put a green, GPS bracelet on my left wrist so that my family would know where I was the whole time, and then quickly back to pre-op.

My nurse was from Arkansas, and she told me to "Bless [my] heart" which made me smile. They numbed my hand and put in an IV. They drew my blood. They asked me questions, and when they got to the pain scale, she frowned and gave me morphine. And more morphine. And more morphine. On 8 ml of morphine, still talking, still remembering, they shrugged and told me I was tough. My dad went to my apartment and woke up my husband, who sat with me and told me it was going to be ok.

My Arkansas nurse turned her head, and ignored the 1-person-at-a-time rule for pre-op. I had five people clustered around my bed, plus the ever rotating circle of hospital faces- the priest, the nurses, the anesthesiologist, the doctor, the operating room nurse. It was a tiny party of hope. Half an hour before things really got started, my family one by one kissed my forehead and went to wait. I told my husband that I loved him more than anything, and that if things got complicated they should burn me and bury my ashes by the rosebushes. He held my hand until they put something from a little brown bottle into my IV, and I went dark as they began to wheel me down the hall.

I woke up with a little warning bell, and a small friendly nurse whose face is blurred told me "keep breathing."
I kept breathing.
Over the next duration of time she told me that until I realized, when the bells were going off, that I should keep breathing. Some time after that, they admitted me to post-op short stay. 
I lost my little GPS bracelet.

They slid me from my transport bed into my staying bed, and it hurt. My husband watched over me, and my nurse was so attentive with her long dark hair and her worried eyes. The first time I tried to go to the bathroom it hurt so bad that I couldn't stop crying and shaking. We stopped trying to get up for a few hours after that. Morphine, vicodin, dilautin, percocet, barely controlling. more medicine. Finally able to get up to use a commode, tears of relief.

Morning shift change, the next nurse saw that my surgeon had planned on me going home same day, and wasn't sure why I was still there. She pushed and pushed for me to do more until she ended up catching me as I cried because I couldn't walk any further. Sympathy then, and more drugs. I threw up breakfast, and more sympathy. Calls to my doctor kept me in short stay until after dinner, when I had kept down two meals, and ordered me stronger pain medications.
My parents helped get me settled in on the couch, under my husband's ever viligant assistant nurse training, and then they did the dishes and went home. My husband helped move me from place to place, and his parents flew in from Germany. A week long blur of visits and food and flowers and more medications. Relief that now, the only pain is incision pain. Relief that this ordeal is over. Relief that I've finally stopped bleeding.

Now, sitting by myself at my desk, which I walked to with no assistance, now my mind is clear enough to think

Why didn't I know about this second baby, who lived inside of me for ten weeks?

It's a legitimate question, really.

Google Image!

It was Fat Tuesday, yesterday. I was reminded by the only hard rock radio station in P-town, which is only fitting. Mardi Gras is a celebration of plenty that much of the world, Catholic or not, takes part in. The shining beads, the funny cake, the drinking- a giant blowing off of steam early in the year when the other holiday (valentines) is rather exclusive and not prone to the kegger-style excess.

I bought myself a book.
I'd say it was for Fat Tuesday, but really, I bought the book because I wanted it, because buying it was the same amount that I'd pay for gas to go borrow my friend's copy, because I get a sick little joy in my heart from having a copy of a book. I like the exclusivity of my three 6 foot bookshelves. I like being able to take my books into the bath, to leave them lying around face down, to dog-ear the pages that I want to whisper to myself when I'm home alone.
It's a lovely book. If you haven't read Patrick Rothfuss, you should. It'll take you some time, but it's worth all several thousand pages to work your way through The Name of the Wind and A Wise Man's Fear.

Image de la Google.

Lent, the forgotten reason for the mardi gras celebration, started today. I didn't go to mass. I'm not Catholic, and I barely have time to function as a normal human being any day of the week. I know God understands my predicament. I'm still in love with the idea of Lent, even if I'm not going to church to share the experience. A whole 40 days, set aside as a social time for the betterment of self, should be more trans-religion than mardi gras. Isn't that the point of any religion, to have rules for being the best person you can be, no matter what customs you follow?

But alcohol and cake is a little more acceptable to the world at large. Cake and alcohol is easy.

And usually far tastier than whatever it was that you just gave up for Lent.(Though, you don't have to give anything up. You can add things to your life. The whole time is just set aside for personal development.)
I have a friend who's given up facebook, a friend who's given up coffee, some who will only drink coffee and water (nothing else), some who are going to exercise three times a week, friends who give up sugar, who give up...whatever it is that's holding them back.  Or add, whatever they think will enrich their life.

January resolutions are great and all, but just seeing if it's possible to do something for 40 days feels a little easier. I like deadlines. I can do almost anything for 40 days. There are some things that just won't fly, like giving up my chocolate or coffee. There are some things that I can't promise myself, like working out. (ask me sometime how it feels to bleed for just about 30 days straight. There's some anemia you just can't lift weights on, and nothing to be done about it other than to wait for new blood to be made.) There are some things that I'm not ready to do- 40 days of silence, 40 days of fasting, 40 days of not reading for fun, 40 days of waking up at 4:30, 40 days of a lot of other things.

This year, because I can't imagine taking anything else away from my life, I'm adding. This year, for forty days, I'm going to meditate once a day. And maybe write about what I find. I'm not giving myself a time limit. If I only get a minute in, great. I don't want to judge myself for not living up to some imaginary number that I've got as the perfect amount of meditation. I would like to cultivate peace and stillness in my life, if only for a minute or so a day. I found the image below, and I would like to feel like that greeting.

Image courtesy of Google.

What can you do in 40 days?

Laundry Mountains, Take Home Tests, and Being Tired.

Image courtesy of Google

Hello, March!
You kinda snuck up on me here. It's hard to believe that there's only three weeks left in this quarter of medical school, and that so soon I'll be done with the first year of medical school. This is the first week that I don't have a test in anything for the quarter, so I'm going to use the breathing room to finish all of the take home work that has been posted so far- my clinical correlates final, my biochemistry homework, maybe the biochem tutorial final. As well as, of course, studying for the finals I have next week.The paperwork never stops, and if it does, there's certainly housework left to do. (Oh, laundry mountain. Someday I will level you.)

Image courtesy of google

I've learned a lot this quarter. Abdominal exams, kidney function, communication styles (I'm sanguine/melancholic, in case you wondered.). I've been a patient nearly every week- this is the first week I've given myself off from appointments, though I still wonder if I should call my primary and ask him if I should come in.  I've learned about procedure and blood tests and grief. I've learned how much you can really find on the internet, if you try, and that mostly, none of it is ever good.  I've handled a human face cut into "book" form in lab, learned how protein digestion works in infinitesimally small steps. I know what happens to my food after I eat it, from the cephalic phase to the last mass movement.

 I'm so tired. I'm tired of everything. I'll be glad to rest over spring break, during those 4 days that we'll be away at the beach. I'm not exactly burned out, because I still love what I'm doing. I'm just burned out in interaction, at home, in motivation. I need some time to just be away, to read a book, to lay next to the husband all day and be quiet, to soak in a hot tub without thinking of how much more I need to do. I'll be glad to be still.

Image courtesy of google.