Getting Back into the Routine

Let me go back to telling my story. Where I left off three posts ago, Joe and I had just gotten home from lunch after my procedure...

Aside from going to the pharmacy and answering the door when flowers were delivered, I didn't want to allow much to happen over the next few days. We were still recovering from the screeching halt we'd just come to, and I really didn't know what we could or should do at that point. I didn't even answer when the phone rang. I just let it go to voicemail.

But we did have two visitors on the afternoon of the surgery. Joe's parents stopped at our house on their way home from a winter in Florida. When my mother-in-law hugged me, I cried a little bit, but that was all I could muster. And I felt as though someone else was speaking as I asked them if they wanted to know what had happened and I explained the probable causes of our loss (intellectualization).

My mom and sisters came to visit the next day, and they got me to join them for lunch at a Mexican restaurant (it was Cinco de Mayo). It was such a beautiful, sunny day, and such a big part of me wanted to enjoy it, but there was also a part of me that was dying to go back home and be alone with my husband. The restaurant was so happy and noisy. And there I was with tired eyes from lack of sleep, making an effort to smile at the waiter as I placed my order. I felt like an intruder.

We rented a movie that afternoon, and it was so hard to pay any attention to what was happening with the characters. Who cared if this couple had to move to the middle of nowhere and deal with hicks and bears and whatever else? I went back to my room and laid down for a while. I couldn't stand that actress anyway.

When the movie was over and we sat quietly looking at each other, I asked my mom and sisters if I could just talk. I showed them the poem I'd written and the information I'd printed about cystic hygromas, and they listened for as long as I needed them to. I felt like a wounded animal on the side of the road, limping along in order to demonstrate that I would run again. But then I remembered that they had sadness as well--the loss of a grandchild and a niece or a nephew. We were all wounded.

When they left, it was quiet again, and Joe and I did whatever it was that we did during those first few days for the rest of the evening. I can't even remember what that was. But we both knew that it couldn't go on for much longer. Joe had missed three days of work, and I hadn't been to the VA since Saturday morning (it was Wednesday night). We agreed that we would both go back to work the next day. We were looking for a distraction.

I found out when the team was rounding with the attending that next morning, and I arrived then. The attending and the other med student were the same, but the residents had rotated while I was gone. I introduced myself to the new team, and I could tell that they were trying to decide for themselves what my role would be for the next few weeks. What could I do? What could they say to me?

Fortunately, my attending was aware of everything that had happened. Without going into too much detail, I will tell you that she was able to understand me in a way that I would have never expected. She was surprised to see me back so soon, and she told me to go at my own pace. There would be no pressure from her or anyone else on the team.

I did go slow for the rest of that week. I saw one patient the next morning, and then only two each morning after that. By the next week, I was interviewing some new admits, but I cancelled my ER shift and I left early on most days. I only did what I could, and I was so grateful to know that that was all that was expected of me.

I tried to avoid down time, but the VA was unusually slow for several days after I came back, and I often found myself wandering around the internet or just sitting with my thoughts. This happened one morning, and the thoughts were too sad. Tears started to fall, and I didn't even wipe them away. I just sat there like nothing was happening. One of the residents could see me from across the work room, though, and she waited until I was done crying before she asked me if I wanted to talk. She knew part of my story, and I told her a little bit more. She asked me questions, and I was surprised to find out how much I wanted to answer them. Talking about myself was exactly what I needed, not all of the time, but at least at that moment.

It turns out, a lot of the residents at the VA knew part of my story. The word must have gotten around. I found this out after morning report one day. I remember that I had sat slumped down in my chair with a particularly grumpy scowl on my face that morning, and I had felt bad for disrespecting the chief resident afterwards. As everyone was leaving, he approached me and I was sure that he was going to demand to know why I had not participated in that morning's discussion. But instead, he put his arm around me and asked if I was doing okay. I never ceased to be amazed by how supported I really was by these people that I barely knew.

That was at the VA, though. Soon I was done there, and I discovered that I was afraid to go back to my school for the remaining outpatient half of my Internal Medicine rotation. First of all, no one there really knew what had happened. Second, my pregnant classmates were there. My pregnant classmates whose plans were still in place, whose babies were still on the way. And moving on to the second half of the rotation meant new stressors and challenges that I was not ready to face, namely the OSCE (standardized patient exam) and the shelf exam.

On my first day back on campus, we started with a brief orientation to the outpatient clinic and the OSCE. Maybe I was completely overwhelmed, or maybe it was just a bad morning, but it started with a sniffle and quickly progressed to snot and tears running down my face. I was bawling in front of everyone, and no one knew why, at least I don't think they did. This continued until the orientation was over. At that time, I was supposed to leave for clinic, but I couldn't move. Then I was asked to leave, and I looked up from my box of kleenexes. I had caused such a scene. My classmates were speechless. I finally got up and left the room.

One of my classmates who had been more successful than I in leaving the classroom was waiting for me in the hall. He just looked at me and said, "Here... You sit in this room, and I'll go talk to them in clinic. I'll just tell them you're going to be late." I dutifully sat in the classroom adjacent to where we had just been and covered my face with my hands. Our clinic supervisor came in shortly after. She was calm, and her voice was kind, but she wanted to know why I was going to be late. I hated the words "I had a miscarriage" as I forced them out between sniffles and sobs. She talked me through it. Miraculously, I was seeing patients twenty minutes later.

Things went better after that, but I missed the fact that no one at the VA had been pregnant. There aren't many Vietnam vets going into labor these days. And somehow the VA nurses weren't drinking the same water that they were at the University Hospital. Pregnant women were suddenly everywhere around me. And who could forget that poster in the radiology department asking "Are You Pregnant?" I walked by it every day.

Some days it was too much, but I did find some people in this new setting that I could talk to. This was so important. I can remember more than one afternoon when I arrived early to lecture to find one of my chosen confidants there. All I had to do was ask if we could go talk for a minute, and she would follow me to the student room where I could cry behind the closed door.

That is my biggest piece of advice for anyone who has miscarried and is now faced with returning to school or the workplace. Find the people you can trust, and let them be there for you. I found that people were more than willing to listen, even if they weren't sure what else they could offer. When you're enlisting these people, remember to include someone in a supervisory role, if at all possible. It is so important to have someone who can go to bat for you that knows your situation. They can really help you when you're struggling.

Don't push yourself too hard or too fast. Go back to work only when you're ready, and don't go back at full speed. Don't throw yourself too deep into the old routine too quickly. Remember to allow your feelings to come to the surface every once and a while, and have an outlet that's readily accessible. If certain things are making it harder for you to be at work, identify exactly what those things are and talk to someone about how you can adapt.

And just know this. As with all other challenges that follow a miscarriage, this too will eventually get easier.

(What I'm listening to right now...)
 Paramore Brand New Eyes

Taking Care of Yourself

After the miscarriage, I wanted to take care of myself. I wanted to find my own strength and my own ways to heal. So when Joe recommended that I make an appointment with a counselor one tearful night, I rejected the idea. I could handle this.

But two weeks went by, and it was clear that I was not handling it. I was becoming so easily overwhelmed, having meltdowns that the people around me couldn't understand. It was time to do something else.

I finally contacted Student Counseling and scheduled an appointment, and I'm so glad I did. It was a chance to talk to someone about my specific needs without feeling like a burden. It was a chance to hear someone else's take on the situation instead of trying to analyze it on my own. And it allowed me to recognize and label what I was going through as grief.

Instead of concentrating on what happened, my counselor chose to focus on how to move forward. We talked about the resources that were available, and he helped me to think of new ways to help myself.

He gave me this advice:

Pay attention to the things that make you happy. When you find something, enjoy it and remember it. Don't be afraid to let yourself be happy.

I took his advice, and I started to pay attention, not only to my sadness, but to my happiness as well. Here's what I found:

I found a way to spoil myself, simple and just a little bit extravagant. At the hospital, there's a Starbucks coffee cart where I learned to order the raspberry white chocolate mocha (or a "red and white" if you want to sound more savvy). This is the sweetest, best thing I've found, and it's surprisingly pink for coffee. It's also one of the highest calorie items on the menu, but I did mention that I was trying to spoil myself.

I found something that made me laugh, and I found it on TV. Two shows--America's Funniest Videos and the more adult version, Tosh.O. There's just something about watching people hurt themselves. When I'm laughing at their expense, I try to take a second to feel bad, but who doesn't laugh when a grown man gets run over by his toddler in a Big Wheels convertible? I was even able to laugh at the giggling babies.

Lastly, I found something that made me feel good. It wasn't until four months after the miscarriage, but I eventually started going to the gym. One of my favorite things became listening to my iPod while running on the treadmill. This provided me with time to think, but my thoughts were usually more positive when I was working out. Sometimes the music I listened to was too sad or too happy, and I would tear up, but running was cathartic that way.

If you are grieving, I encourage you to look for the things that make you happy too. Let your happiness be guilt-free if you can. There will be plenty of opportunities to be sad.

And I encourage you to seek out your equivalent to my Student Counseling. Grief counseling helps, and grief is not something you should try to take care of by yourself.

(What I'm listening to right now...)
 Sia "I'm In Here"

Not Pregnant

Most of the changes that happen to us are gradual, barely visible. In fact, many important milestones in our lives happen without our even noticing. Can you remember the morning when you woke up and you were suddenly an adult? It probably didn't happen that way.

But there are also life-changing events, specific moments after which nothing can ever be the same. Everyone has a few of these... their first step, first day of school, first car, first date, their wedding day, the death of a loved one. These events become so important that all others are defined by them ("that happened after you started kindergarten... before you were married... right before your grandmother died...").

Finding out that I was pregnant was one such event. One Sunday morning, everything changed. Even as my baby was only the size of a poppy seed, I was already its mother.

What did this mean to me at four weeks pregnant? First of all, it wasn't just "me" anymore. I was responsible for someone else, and it was suddenly very important that I take vitamins, avoid alcohol, wear my seatbelt, wash my hands, drink plenty of water, try to gain a little weight. Making decisions about even the smallest things became a new challenge as an expectant mother... deciding for two. There could be no selfishness. And this was only the beginning.

I fell so madly in love with our baby, too. Just thinking about the little life inside me could bring the silliest grin to my face. I became so eager to meet my son or daughter, and I would write it little love notes in my Belly Book. "You and Mom were scrubbed in for a four hour surgery today!" On the day of our first ultrasound: "Mom and Dad were so excited to see you for the very first time today!"

I couldn't bear the thought of remaining detached, holding back for a little while, and I was willing to accept the vulnerable position I was in, head over heels. By eight weeks, when my lab results came back abnormal, I felt something that I couldn't put into words until I found them in a book: "The human heart was not designed to beat outside the human body, and yet each child represented just that--a parent's heart bared, beating forever outside its chest." My baby, an extension of my self and my body. Even when it was still inside of me, I couldn't protect it from everything.

What I could do was hope and pray and dream about the future, envision myself as a mother. One evening, I begged Joe to drive me past the hospital's main entrance and I could picture it--me in a wheelchair, baby in my arms, a cart full of flowers and balloons. At church, I watched the moms hold their babies, walk their toddlers to the front during communion, sniff dirty diapers and sneak out through the back door during the sermon--that would be me soon enough. And when Joe and I went on walks, I could see the stroller in front of us, our dog stuck in between. I could picture our little family.

These visions were frequent, and it was becoming harder to picture myself without a baby, pregnant or otherwise. Everyday I fell more in love, and everyday I believed more and more in the idea that I was no longer just "me." I loved the responsibility. I ignored my vulnerability.

And then everything changed again, as you know. But more suddenly this time. Another moment with a clear before and after, another very specific point in time. A discovery in a dark ultrasound room. A feeling of things being taken away...

People have asked me why I left the doctor's office through the back door that day. As I approached the waiting room, I pictured the women that would be waiting there. What did I have in common with them anymore? How could I face them and their round bellies, their swollen ankles? I had tried to be like them and failed. I wasn't like them. I couldn't stand the idea of them seeing me and knowing my emptiness, my failure. My bloodshot eyes and tear-streaked face would surely give me away. They were women, but I was just a girl. It was easier to avoid their stares.

Until my procedure the next day, I found myself floating somewhere between pregnant and not pregnant. I was surprised to find out how important it became for me to identify exactly what I "was." What could I call myself? Who was I supposed to be now? But it wasn't until the surgery, walking away without my baby... that's when I became lost in the identity of "not pregnant" again.

Physically "not pregnant." But in the mirror, I still looked pregnant. What was I going to do with this weight I'd put on? I still felt pregnant. There was still enough blood circulating through my veins for the both of us. I hated the thought of watching this all fade away.

Mentally "not pregnant." How could I go back to before? Who had I even been? I couldn't remember that person anymore. And who was I responsible for now that it was just me? I wanted that back. I wanted it to matter what I ate and what I drank.

Emotionally "not pregnant." Could I really be a mother one day, and not a mother the next? And what about my broken heart? My husband's? How could God let us fall so in love with this baby, only to take it away? What about those dreams of myself as a mother, dreams of us as a family--had those also been a lie?

When all of this was happening, I didn't know where to find the answers. And I still don't really have the answers, but I can tell you how I learned to deal with the questions.

When I avoided the waiting room: What did I have in common with those pregnant women? I've talked to lots of people about my miscarriage now, and I've learned how common it really is. And I've also learned that you can't tell by looking at a person if they know that pain. I don't think that many people could guess that I've miscarried by looking at me now. My point is that at least a third of the women in that room probably would have seen my tears and understood my pain, having felt it themselves.

When I thought that I wasn't a woman like they were, I couldn't have been more wrong. To know the pain of miscarriage is something uniquely "woman." To love a child and have to let it go is something uniquely "mother." As for those pregnant women and mothers who have been fortunate to avoid such a loss, they still know what it means to be in love and to be completely vulnerable. We have more in common with eachother than we know.

After the surgery: How could I go back to who I was before? I couldn't. It didn't matter that I couldn't remember the "just me" from before, because that person was gone. Just because the pregnancy was over didn't mean that I hadn't been permanently changed by it. I wouldn't ever be the same again--I didn't have to be.

And who was I supposed to be responsible for now? It was hard for me to accept that I was now the only one walking around in my body. I had a new task at hand, though. Taking care of myself would become very important over the next few months. Taking care of my husband, too. Taking care of myself for his sake. Working hard to keep my head above water.

The hardest question for me was the next one: Could I really be a mother one day, and not a mother the next? The answer was and is no. I am still that baby's mother. I have this advice now for people who have recently miscarried:

You're still a mom, even after your baby has died. You are the most important person that that baby ever knew, and you always will be. Your baby is still right there with you, and it always will be. Because you'll always be it's mom.

Always.

(What I'm listening to right now...)
 Incubus Morning View

Falling Asleep

I don't think that I slept for more than an hour on the night after we found out about our miscarriage. And this was just the first of many terrible nights. My new sleep pattern would become something like this...

First of all, I wouldn't even try to go to bed until at least eleven o'clock. My bedroom became the place that was too dark, too quiet. My despair was uninhibited there, and being alone with my thoughts was torture, so I was never in a hurry to go to bed. When I did go there, I would try to distract myself from thinking until sleep caught up with me. I read the same short stories over and over. They were about nothing at all, and they came from a book that still sits on my bedside table. When that didn't work, I would listen to sad songs on my iPod, and sometimes I would do both at the same time. Of course, I often talked to Joe too, but he has always been better at quieting his thoughts and falling asleep than I am.

When I was ready, I would turn my iPod and the lamp off and just wait. Sometimes my eyes and my mind were so tired that I actually did fall asleep, but it was more common for me to spend the next few hours with a combination of thoughts. First, I would replay an event--sometimes these were happy events that occurred during my pregnancy, and these were always followed by a deep sense of loss. Other times, I would recall the events leading up to the miscarriage, and I would scold myself for ignoring the signs. And then there were the memories of the miscarriage itself--the phone call, the ultrasound, the surgery.

Next came the anger and the sense of betrayal, the question "Why?". If my thoughts became too dark, I would wake Joe or turn the light back on. And once this had passed, I would reluctantly pray to a God whom I wasn't sure was listening. I prayed for three things: that God would be with our poor baby and welcome it into Heaven, that God would help me to be strong and find a way to get through this, and that He would teach me to have faith again. If I was able to fall asleep, it was usually sometime shortly after this prayer.

And then I would wake again, sometimes thirty minutes later, sometimes three or four hours later if I was lucky. Many times, I woke up with tears streaming down my face. This was the first time since I was a little girl that I was sobbing, and I was doing it in my sleep. Other times, I would wake up from a dream where I was still pregnant, and then I would have to remind myself that I actually wasn't. And then there were the dreams about miscarrying. Sometimes I actually woke up convinced that it had all been a dream.

I wish I could say that I eventually found a way to fall asleep. I wish that I had found a way to quiet my own thoughts in the middle of the night. Somehow, I did get over these problems, because they no longer persist, but I can only speculate as to what actually helped. There were several things that I tried, and they were all kind of hit or miss, but I think that each one worked for me at least once.

One of the things that I tried was picking a word and "breathing" it. My word was usually "peace," and I would think it in my head as I exhaled slowly. Of course there was prayer too, and I mentioned that I had a hard time with this. I'll get into that more as I continue to blog. Eventually, my faith did grow stronger and prayer became easier.

Another important thing that I practiced was talking myself down from repetitive negativity. When I found myself thinking "It's not fair, it's not fair, it's not fair..." over and over, I'd come back with something like "It happened, and it happens to a lot of people, it happens, it happens, it happens..." I had to develop little pep talks for myself--things like "Tomorrow you'll be one day closer to having a baby, whenever that's meant to happen."

Lastly, I found it really helpful to keep a notebook by my bed, so that, when that positive self-talk did happen, I could write it down. On the night after my surgery, the second night after finding out about the miscarriage, I found myself writing in my notebook. It was three o’clock in the morning, and instead of sleeping, I was writing down all of the things that had happened over the past few days to remind me of my baby's continued presence. When the list was complete, I went to the computer and I wrote this poem:

(What I'm listening to right now...)
Veruca Salt American Thighs

Our Miscarriage: Part 2

My procedure was scheduled for eight o'clock in the morning, so my husband and I arrived at the outpatient surgical center bright and early. I wore my sunglasses into the building, and Joe did most of the talking at check-in. I put up my wrist and they gave me my wristband.

I think I remember filling out some forms, and I know I remember giving a urine sample because of how difficult it was after being NPO for eight hours. We found two chairs in the corner of the waiting room, and we sat and looked at the other people.

It wasn't that long before they called me back. At their request, I went back to pre-op by myself. They took my vitals and then showed me to a curtained-off area where my nurse was getting some paperwork ready. She had a lot of questions for me, and then she had me change into a gown. When I returned, she helped me fit my hair into a cap, and she took my earrings. As she was covering my wedding ring with tape, she told me that she was sorry that I had to go through this. She herself had had three miscarriages.

As I climbed onto the gurney, it all became very real. I was the patient, and I was going to the OR. I started to think about the surgeries I'd seen on my rotations and how those patients had looked there on the table. That was going to be me--totally exposed and in the hands of my OB and the OR nurses and staff. They were going to position me, strap me down, put a tube down my throat, tape my eyes shut, all of those things. I'd seen it a hundred times.

I tried not to think about it too much as the nurse struggled to get an IV. She called in another nurse for help, and an IV was placed by the third stick. Fluids were started, my EKG leads were placed, and then the nurse left to speak with the anesthesiologist. When she came back, she gave me a combination of sedatives through my IV.

They let Joe come back after that. I remember wondering what I looked like to him, hooked up to monitors and an IV, and wishing that he was seeing me like this under better circumstances, like in a delivery room. They put his chair next to me, and he sat and held my hand.

Soon, the OB arrived, and she talked to us both. I wish I could remember that part, but the sedative had started to take effect. She left, and the nurse asked Joe to return to the waiting room. Then they were wheeling me towards the operating room. It was so strange to be pushed on a bed from one room to the next.

As they got closer, I heard music, and when they opened the door, it poured out of the room. "Say Hey (I Love You)" by Michael Franti & Spearhead was playing on the radio. Maybe they were trying to lift my spirits. Or maybe I was supposed to pretend I was listening to reggae somewhere in the Carribean. Maybe it's just what was on the radio. I don't know, I was out of it.

They put on the gurney's brakes, and I was hoisted onto the table by a small group of people. I remember being told that they were just going to "hug [me] with some blankets now..." and "give [me] a little oxygen now..."

When I opened my eyes, I was back in a curtained area. I remember feeling like I was enveloped by a cloud. My head was resting on at least three pillows, and my body was covered by this long, flat balloon and it was so delightfully warm under that thing. I felt like I had just come out of hibernation. I felt like Sleeping Beauty. A different nurse was there, and I asked her if they had done the surgery. They had--it was over. The doctor had spoken with my husband, and now she was gone. I had been sleeping for a long time.

I asked her if I still had a uterus, and she laughed and said that I did. She offered me some cran-apple juice, and you would have thought that she had just offered me a winning lottery ticket. I downed that, so she got me some more. She ran her fingers through my hair and put chapstick on my lips. She was like an angel. I remember thanking her a lot and telling her that she was "just so nice." She talked to me about her miscarriage--she had also had one many years ago--and she told me that she understood what I was going through.

After a little while, she asked me if I thought I was ready to sit up yet, so I tried. Then she helped me to stand up, and I changed back into my clothes. Soon, we were leaving the curtained area, and she took my vitals one more time. Joe came back and joined me at that point, and we went over my post-op instructions with the nurse.

As we walked out of the surgical center into the sunlight, I knew that it was just me now. I wasn't pregnant anymore. And as we pulled out of the parking lot, I was aware that we were leaving what was left of our little baby behind. I felt sad that it was alone now too and probably on its way to a pathology lab somewhere.

Part of our instructions had been to go out for a nice lunch so that I could finally have something to eat. We picked a cafe where they served good breakfast food so that I could find something bland on the menu. When they seated us, we asked for a table outside, and when they put us too close to the other guests, we moved to a table on the edge of the outdoor seating area. The sun was beating down on us, but I liked feeling warm and it gave me an excuse to keep my sunglasses on.

The waiter brought Joe his Belgian waffle and he brought me my toast and scrambled eggs. I finished what I could eat, and I was just looking around, when I noticed a little bird that had hopped down onto the sidewalk from a planter nearby. I smiled as it hopped towards me. I could see that the little feathers on top of its head were all messed up. It sort of cocked its head to the side in this cute little way, like it was saying "Hey you!" And then it let out two little peeps, hopped closer, then flew away. I asked Joe, "Did you see that?" With tears in my eyes, I told him how I thought our baby would have giggled at that little bird.

And when we got home, I cut the solitary tulip that had grown amongst the hostas in our front yard. I brought it into the house, and I put it in a vase I'd found.

I couldn't explain it, but these things brought me comfort: the warmth of the sun, two peeps from a silly little bird, and a misfit tulip that was far from its flower bed.

(What I'm listening to right now...)
Simon & Garfunkel "Bookends"

Our Miscarriage: Part 1

It was a Monday morning, the first Monday in May, and I can remember it like it was yesterday. I can remember what I was thinking on that very morning. 'I am going to treat this day like just another day--maybe it will be just another day.'

I remember getting out of bed and getting dressed for work, hoping that that's where I would be headed after this brief stop at the doctor's office to make sure that everything was okay. I remember my conversation with my husband. He asked me if I was sure I didn't need him to go with me, and I told him that it would be fine and I would just call him.

I remember my phone ringing as I was trying to head out the door. It was a reference calling about a daycare that we had recently toured. We had really liked that daycare--it was probably the one we were going to go with.

I remember parking my car in front of my OB's office, saying a little prayer, and taking a deep breath. 'Just another day.' I remember explaining to the receptionist why I was there without an appointment, and I remember sitting in the waiting room for an hour, bladder full in anticipation of an ultrasound.

The nurse called my name, and I remember telling myself to smile. She took my vitals and showed me to an exam room where I waited some more, telling myself not to cry as I cried anyway. The doctor came in, and she seemed startled when I looked up at her with tears in my eyes. She showed me to the ultrasound room.

I remember that the room was different that morning. There was concern in the air, and it seemed darker. I remember looking at the screen and trying so hard to see life there. The sonographer was trying too, and I remember feeling like she wanted my little baby to be alive just as badly as I did. She tried for so long before I finally looked away from the screen and at her--I didn't say anything, but she knew that I understood and that she could stop. She said she was so sorry, and she helped me to sit up.

The doctor came in, and she just hugged me. I pressed my face into her shoulder and I cried in a way I'd never cried before. She gave me a few minutes, and then we talked about what needed to happen next. She wanted me to go home and talk with Joe and then call her back later that day. We would need to arrange an outpatient surgery because my body was still trying to hold on to the pregnancy.

As I was getting ready to leave, I asked the sonographer and the doctor if there had been any signs that this was going to happen. They told me that my previous ultrasound had shown a cystic hygroma, and our baby had probably had a chromosomal abnormality like Down syndrome or Turner syndrome.

We were walking toward the check-out area when I stopped and handed my paperwork to the sonographer. I asked her if I could just leave through the fire exit at the other end of the hall. I was so grateful when she didn't ask me any questions. She sent me back down the hall, and I found my way out without having to face anyone. I just got in my car. A part of me had died.

Joe came right home. He found me sitting on the floor. Our dog sat next to me, confused and wanting to help. Joe sat next to us, and we stayed there for a long time. He was crying in a way that he'd never cried before.

I called the doctor back later that day, and we set up my procedure for the next morning. After that, I can't remember what I did for the rest of the day, but I do remember sitting in our bedroom and listening as Joe called our parents, and my heart broke a little more each time the words fell into the telephone receiver: "We had a miscarriage." I could hear their hearts breaking on the other end of the line.

At the end of the day, I found my Belly Book and I wrote the following entry:

"Mon. May 3: Today we found out that we won't get to meet you yet--that you've already gone to heaven. Your Dad and I are very sad. We will tell your brothers and sisters about you someday when they are old enough. We have loved you from the very first day, and we will never forget you. Love, your Mom."

(What I'm listening to right now...)
 Cat Power "Sea of Love"

Our Pregnancy: Part 3

Once both sides of our immediate families had heard the good news about our pregnancy, we were off and running. We were telling almost everyone we ran into and "the announcement" was becoming a daily routine. On the weekend after Easter, Joe and I went out for dinner with a group of friends called the ABC Club (we go to a restaurant starting with a different letter of the alphabet every month). On this occasion, we decided to try out what became one of our favorite ways to tell people--Joe reached for the margarita pitcher and made sure enough people could hear him before saying, "After all, I am drinking for three now."

The next step was authorizing our parents to start spreading the word which resulted in a string of phone calls from excited aunts and uncles. We made sure to call all of our grandparents first, and I even had the privilege of letting my great grandpa know that he was going to be a great great grandpa.

In the back of my mind, I thought about what it would be like to have to get the bad news to all of these people if something terrible were to happen, but I always managed to ignore this concern. I felt like waiting to tell people meant that I didn't believe the pregnancy would make it, and I wanted to have faith. This is what I told myself when a friend at my parents' church heard "the announcement" and found a moment to talk with me privately. She said, "You should be careful about telling too many people too early. You just never know what will happen." But we forged ahead.

Meanwhile, we were starting to do some prep work. We made our first trip to Babies 'R Us to price cribs and changing tables and to brainstorm nursery themes. We started researching daycares and we even went on a couple of tours with a long list of questions in hand regarding everything from fire drills and passed inspections to diaper and formula storage logistics. After deciding how we would rearrange our home in order to accommodate a nursery, we even started work on the basement storage area that would become an office/guest room.

During this busy time, I also had my first ultrasound and new OB appointment. Joe was there for this, and I wouldn't have had it any other way. I'll never forget that afternoon and that dark little room where we fell in love with our little baby, wiggling around in black and white and shades of gray on the screen. I had tears in my eyes the whole time, but I could only laugh. It was one of the happiest moments of my life. The baby was 1.73 cm long from crown to rump, a little smaller than expected (which pushed our due date back three days). We watched as its heart beat like the flutter of a little wing, 167 beats per minute. The sonographer even showed us some really great 4D Real Time views before handing us our printed pictures.

 

After the ultrasound, the rest of the appointment was uneventful.On the way home, I reached into my purse and pulled out the pictures again. I studied the "4D" images in particular, and I was bothered by one thing--on both pictures, behind the baby's neck, there was this dark, round structure that the sonographer had not identified. "What do you think that is?" I asked Joe, pointing at the dark spot. He told me not to worry, and I didn't for too long. I didn't know that the answer to my question would eventually appear in a radiologist's official read-out of our ultrasound, and I never suspected that a dark spot would shed light on our baby's fate.
Eventually, as everything unraveled, I found myself resenting the fact that no one had really talked to me about this ultrasound finding. In all honesty though, that resentment didn't last very long. I don't think I was supposed to know--knowing would have made me crazy.

Besides, I think that denial was an important theme during our pregnancy, although I haven't decided whether this was good or bad. Let me explain. It was around ten weeks or so when I began to bleed. I was rotating through Internal Medicine and working at the VA Hospital on the day that I discovered this disturbing symptom. It was just a small amount, so I decided to keep an eye on it. As time went on, I found that it would come and go. Every time that it came back, it was gone again before I was concerned enough to call the doctor. This pattern continued for several days before reality finally struck.

It was a Friday evening, and Joe and I were at our friends' apartment making "the announcement," just hanging out. Everyone was watching TV when I excused myself and my pregnant bladder. I went into the bathroom and suddenly realized that I was bleeding significantly more. I was about to panic, but I told myself to breathe. I went back out and started complaining that I suddenly didn't feel well. Soon after, we said our goodbyes, and I waited until we reached the car to tell Joe what was going on. Now I felt safe panicking, and Joe let me cry while still reminding me to breathe.

When we got home, I checked again and the bleeding had stopped, but I knew that it was time to call someone. At first, I got the answering service. They paged my doctor (she was on call that night), and she called back within a few minutes. When I began to tell her my story, she was immediately concerned, but we agreed that it was not necessary for me to be seen in the ER that night. She told me what to do and what to watch for and asked that I come in to the office as soon as it opened on Monday morning. Finding out that my situation was not emergent gave me some reassurance. I went to bed that night and remembered a text message that I had received from a friend earlier that day--"New song - Airplanes - Hayley Williams and B.o.B." That song is now completely overplayed, and I realize that it's kind of cheesy, but I probably listened to it twelve times that night. "I could really use a wish right now, wish right now, wish right now..."

I was scheduled to work at the VA that weekend, so I rounded on my patients the next morning. After the attending dismissed our team, I caught one of the residents in the hallway. I tried to ask her my question without crying, but I broke down--"Do you know if first trimester bleeding is ever normal?" I just needed some hope, some reassurance. Later that afternoon, she called me on my cell phone while Joe and I were at the hardware store. She told me to take the rest of the weekend off and do whatever I needed to do for myself--she had spoken with our attending who actually thought I should be seen in an ER. I hung up the phone and started to cry right there at Lowe's, in the plumbing aisle, next to our shopping cart. Denial could only get me so far, and I was starting to realize that I had reached the end of its potential. Now I could only trust and pray and wait for Monday morning.

(What I'm listening to right now...)
 Alison Krauss and Union Station Lonely Runs Both Ways