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.

A locked up history

Three weeks since onset, the miscarriage is complete and finally over. My second set of ultrasounds, paired with some pretty strong pelvic decongestants, showed a thin layer of endometrium with no remaining tissue or ad nexium abnormalities. I lost a lot more tissue this week, but this time through I think I was ready to lose tissue. At exactly two weeks of blood, my uterus abruptly decided it was done and I was returned to my previously interrupted cycle. My progesterone levels plummeted, corresponding with a drop in base metabolic temperature. I pulled through the worst of the depression, The husband and I are still on the same page, and I quit pasta and chocolate again. I even started working out again, though I quickly learned that I'm not as strong as I was. I took some damage in the process, and that's ok.

While I was previously cursing my "backsliding", a dear friend of mine wrote me a letter which reminded me that "Life isn't linear."  She's absolutely right. It's not fair to myself to hold a standard which is totally unuseful both to myself and to my future patients- Life is so dynamic, so full of these unexpected turns and twists. I did the best I could for myself at each step. I had no self destructive behavior, and even if it feels like I'm restarting a journey that I should be much closer to the end of, I keep reminding my head that my heart took a side trip, and the distance is longer because the circumstances are different.
I did my best.
I was the most careful momma I could be, with my prenatals and my fantastic protein-full diet and my careful exercise. I was the most graceful grieving mother I could be, with my bags of chocolate and my copious tears and my outreach for help when I needed it. Now, it's time to move on and focus on being the best doctor I can be, by using all the good I've found in this experience to develop compassion, to further my relationship with my husband, to rejoice in the support of my friends. To learn what I need, so that when we try to conceive on purpose, the timing will be better and maybe I'll have even dealt with an infant by then. This month at school is going to see 3 boys delivered, and a girl to a young friend in April.
I got my locket, as the pictures suggest. Somehow, clipping the pictures and fixing them to the inside provided so much closure.

Even though I can leave the locket closed, and not look at the experience, knowing that I can see the five weeks when I had a baby inside of me whenever I want is strangely reassuring for me. Like having proof for something that otherwise might have slipped away into the chaos of history unremarked upon. I have the memories locked up around my neck, where they provide so much comfort.

The five pictures are the pictures from after conception. On the backs of them, I've written the scant details of my metal rabbit baby's life. Conceived January eleventh. Due October fourth. Lost February 12th. Though it's hard to tell when the losing really happened- technically, the beta-HCG had dropped a week prior to that, which probably means the losing was earlier. I stopped feeling baby's energy on February ninth, but the tissue loss was the most on the twelfth. That's when I lost the gestational sack, and so my decision for a loss date is the date that the baby actually left my body. There's something nice about having picked a date, even though with my excessive obstetrical knowledge, I know it was a process and not a date. Again, it's the idea that I've made this a concrete thing for myself, that I've made the details of an event solid and impervious to the rushing of history- enclosed in a silver locket, fastened with tiny magnets,hung by sturdy chain near to my heart. A history that I can leave on the bathroom counter, or that I can show someone else.

A history all my own.
                                                   

supported

This weekend was rough for my mind- on friday, admitting I was depressed was the first step.
Then I made things happen- and you, my dear friends, helped immensely.

First, I got an email from a classmate at 1pm on friday which stated simply that she cared about me and wanted me to know that she was still available if I needed anything. Now, this lady is an incredibly strong and sassy woman who is just on the verge of giving birth to twin boys and is going through the same medical program that I am- yet she still found the time to ask me each day if I was doing my biochem homework, scanning in her own study guide and emailing it to me, inviting me over for a fringe marathon at her house. And still, checking on me every day.

Then, my mom's best friend (who rearranged her schedule in college, when I was born, so that my mom could finish her degree) dropped by with bean dip and chips and gave me a much needed hug and talked to me till the late hours.

And then my dear undergrad friend wrote me some emails and a letter or so, and started checking to make sure that I'm still doing ADLs, which I needed. And I miss her so much, it was good to hear from her anyway.

Saturday morning I had another doctor's appointment- I'm in there every week, and on the phone with them so often I have their cell numbers. Things aren't going as well as expected, so I'm taking 5 more treatments than I had been- a tincture and a homeopathic for the emotional shock, homeopathics for pelvic congestion, and a cell salt for the cramping. I had another diagnostic set of ultrasounds, traditionally and transvaginally this morning, and hopefully those results will be in tomorrow.
My primary also used his magic bodywork skills and got my back to loosen up some- after a week of class, I could barely sit up. I'm still having problems with long periods of sitting, but I started my workouts back up again today

Saturday evening, two of my bestest high school dropped by with high tea for 20 people for the 3 of us- chicken pate , salmon and dill, cucumber mint, and cream cheese horseradish finger sandwiches, angel food cake, blueberry scones, english muffins, fruit platters, vegetable platters, four boxes of tea, and more. They washed my dishes and cleaned my kitchen, and then quizzed me on biochem, and then we watched 10 things I hate about you, which is a nice classic feel better movie.

image courtesy of google

Sunday morning, I took a shower and sung my heart out. I invented some blues songs that I cried my way through, and then my husband got home and we went to my parents house and played board games for a few hours. My dad, that crazy generous man, worked seven days in a row so that he could buy me the doctor bag I've had on my wishlist and been saving up for for months. It'll be here on the 24th, he said yesterday. So then I'll have a place to put my stethoscope and my sphygmomanometer, and my ophthalmoscope, and my otoscope and throat illuminator and pen light and the other cool doctor stuff I got during equipment handout last tuesday.

image courtesy of amazon

The husband and I bonded over our loss on the car ride home- talking to his washington boys helped immensely to bring us to the same emotional page, and I'm so glad he has a man-group that he can talk about his feelings with, because it helped us as a couple out a ton.

I'm using the money I was going to put towards my doctor bag to buy a silver locket featuring a rabbit, and then two cherry trees. In the locket, I'm going to put the belly photos with the conception date and all of the miscarriage details.

image courtesy of cosmicfirefly on etsy

The trees we're going to plant at my parents house- and then my little metal rabbit baby will have a little ceremony and a physical reminder to give me some closure about the whole situation. My hubby is thinking he's going to get a tattoo of our our signs (earth dragon and fire rabbit) with what would have been the baby's sign (which is the metal rabbit, in case you missed the chinese new year this year and hadn't picked it up from the above sentances.)

I'm still incredibly sad, but no longer oppressed by my sadness to the point where I wasn't leaving the house or doing my chores. Thank you all- I love you so much. I appreciate all of you ( I know I didn't write all of the kindnesses that have been done these last two weeks- and if I had, this post would be one hundred pages long. You are all so lovely, and I treasure every hug, every card, every letter, every wall post, every email, every set of notes, every recording, and every willing ear.) I'm overwhelmed by your support, and I cherish it.

depression

Here I am. It's a week, just past the hour, exactly, and I'm all alone. My house is filthy. There's ice cream containers on the counter. I've just come to the point, watching my third season of Buffy: The Vampire Slayer and having my water goblet of wine, where I've realized that I'm very depressed, and that I've been using any distraction I can to avoid working through all of these experiences.

It was biochemistry that was my final clue- my midterm that I worked so hard to move to monday morning at 10, so that I could study. I was studying, actually, on thursday morning. I got four questions in on the study guide before I went home, tucked myself under a big blanket on the couch, and turned on the television. This morning I swore I was going to get up and study, but since both teachers for today's classes had told me I should rest, I tucked myself into the couch and turned on the television. I still haven't gotten an inch further. I did turn off the television in the middle of a season. To my surprise, in the dark with no distractions, I burst into tears.

All I could think about was how I've reverted exactly to how I was in October- I've gained back all the weight, I'm just eating easy food and sugar, I'm dizzy, I'm nauseous, I'm exhausted, I have the worst headache of my life, I'm behind in all of my classes- and this time, I feel like a giant failure on top of it. I failed to be healthy. I failed my second chance at pregnancy. I'm afraid I'm failing my classes. I feel like I'm failing my husband, my family, my friends. I don't know what to talk about, or what to ask for.

I feel like I'm slipping away.  It sounds so stupid, so childish, but there for five weeks, I felt so special and beautiful. Now I'm neither. I've tried to talk to the school counselor, but our schedules haven't matched up. Even my primary has been too busy to call, though he said he would. The main doctor said she'd call today too, but she didn't. And the husband is off with the guys, on an excursion that they planned weeks and weeks ago when things were good. I don't want to be by myself, but I have another doctor's appointment in the morning, and it's too far to commute in from my folks' place. All the friends I would have been comfortable asking to come stay with me are in other states.

I guess I just need someone to kick my ass into line and motivate me and be with me, but since there's no one but me, I'll have to work up to it. I've just been too afraid to start up again. When my roommate died in '08, I worked 12 hour days for 16 days straight. I worked through the tears and the sadness until I was just empty inside, and then it all came back in the first bodywork class I took, and I had to deal with it again. I don't want to do that this time, but I don't know how to get functional again without doing that. and did I mention biochemistry? I have to pass this test, because I failed the first one. I don't have time to sit around and be sad.

But I am. And that's just what I've been doing...

miscarriage

It's a strange and horrible thing for your child to die inside of you- to be aware of the sickening loss of sensation followed by the pain building and intensifying. To watch the red, red blood fall away while the fire burns away at your spine.
It's had to see the blood, knowing that somewhere in those masses of tissue, there's a clump of cells that used to have a soul so large that I could feel it two feet away from my body.
My uterus is locked in spasm. My lumbar vertebrae and sacrum are compressing, caught on cold fire and aghast at the horror in front of them. The muscles of my abdomen twitch and writhe. The ligaments expanding into my inguinal canal are shuddering as my heart beats too fast and my throat closes up and tears fill my eyes.
Goodbye, my little love.