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

Our Pregnancy: Part 2

Two days after my "confirmation of pregnancy," my husband and I were on our way to Jamaica, still excited as ever and finally ready to share the news with family. This trip was a family vacation with his parents, brothers, and their wives, and they were going to be the first to know. We decided that we would tell everyone over breakfast on the second day of the trip, which also happened to be my 25th birthday. I told Joe that he had to do it, so he dutifully asked for everyone's attention as the last person was sitting down to the table. He raised his glass of orange juice and offered a toast. After thanking his parents for an amazing vacation (it was their Christmas gift to the family) he proceeded to congratulate them on becoming grandparents again. The whole table erupted with excitement, there were hugs and jokes about paternity from Joe's brothers, and then we settled into a relaxing week where I no longer had to hide my "glow" and I got to eat as much as I wanted while the rest of the family drank Red Stripe and rum runners.

On our fourth evening in Jamaica, halfway through the trip, I decided to check my voice-mail and was surprised to find three messages from my OB's office. None of the messages were very informative, but each one sounded more urgent than the last. The nurse was actually starting to sound pretty annoyed by the third message, stating that she was "going to stop calling" if I didn't return her call by the next day (which seemed pretty unprofessional to me, but that's besides the point). It was after hours, so I tried leaving a message with the answering service to let that nurse know that I was currently in Jamaica, but I was unable to do so. When I got off the phone, I told Joe's family about the messages and retreated to our room. This marked the beginning of the "worried phase" of our pregnancy.

On the next morning, I started trying to call the office at 8:45 (they opened at 9:00). I called repeatedly until, finally, their phones turned over. "Hello, my name's Kristin McGregor, and I have a message from _____ to call and speak with a nurse." "One moment please..." "Hi, this is Kristin McGregor... you had been trying to get a hold of me for the past three days, and I just got your messages..." My blood tests had revealed an abnormally low progesterone level (this is the hormone that supports gestation and is initially produced by the ovaries in response to hCG). The nurse instructed me to begin taking prescription progesterone as soon as possible. Unfortunately, I would be unable to start this medication until I returned to the United States, and so the second half of my vacation took an unexpected turn as I waited impatiently and worried incessantly.

On the plane ride back into the states, it occurred to me that my pharmacy would be closing before I could get there. As soon as we hit the runway and the use of electronic devices was permitted, I was on the phone with the pharmacist. Apparently, my OB's office had neglected to call in my prescription as promised. That was it for me--I fell apart, and my husband struggled to gather my belongings and get me off the plane. As we headed towards customs, I made one frantic phone call after the next. I finally reached the on-call physician and I fought through tears and bad reception as I tried to get him to understand my situation and the importance of calling my pharmacy before they closed for Easter. A little later, I called the pharmacist--they still hadn't heard. I called my friend--she was in line at the pharmacy but there was no prescription yet. Finally, the prescription was called in, ten minutes before closing time on Easter Saturday, filled and paid for and on its way to my friend's apartment where I later picked it up. What a nightmare. I am eternally grateful to that pharmacist and that friend who went completely above and beyond for me.

Starting the prescription helped to ease some of my anxiety, and Joe and I decided to go ahead and continue telling immediate family our happy news. We decided to tell my parents and sisters on Easter Sunday. Because we were in the midst of birthday season (my sisters and I all have birthdays within a seventeen-day period in late March and early April), Joe and I decided that the announcement should come during the gift opening. We presented my parents with a card. It was covered with brightly colored bunnies and Easter eggs, and it said "Happy Easter, Grandma and Grandpa!" When my parents opened the card, they found a signature in my hand-writing, "Love, Baby McGregor." Then came the tears and endless hugs from baby's newly expectant aunts and grandparents. There was also a request for a preview of what my belly would look like months down the road, which I dutifully indulged with my best big belly impressions.We were well into the "worried phase," but our pregnancy was still fun and exciting.

Joe and I did a lot of talking during this time, and we encouraged each other to have faith and trust that our baby was fine and our pregnancy would continue to go well. We prayed a lot--we prayed to ourselves, and we took turns praying out loud. We always asked for the same things, mostly a healthy baby and an end to all of the worry. It's strange to think about those prayers now, knowing the outcome. I know that God was listening--I have no doubt about that. I realize that He had other plans than the things that we were asking for, and even though I was angry about that for a long time, I'm finally getting closer to acceptance. I'm trying to look at our short pregnancy and what followed as a small but important part in His big plan for me and my whole life, a plan that has brought me so many blessings but just happened to include this unexpected event that I will never fully understand.

"Trust in the Lord with all your heart, and lean not on your own understanding; in all your ways acknowledge Him, and He shall direct your paths." (Proverbs 3:5)

(What I'm listening to right now...)
 Various Artists Juno - Music from the Motion Picture

Our Pregnancy: Part 1

Early in the morning on Sunday, March 14, 2010, I crawled out of bed without a sound. Joe and the dog were fast asleep, but I had been awake for most of the night thinking about the pregnancy test hidden below the bathroom sink.

I closed the bedroom door behind me, crossed the hall, and located the orange box with the word "ANSWER" on the front, "EARLY RESULT." Hands shaking, I followed the instructions to the letter, and then I sat and stared at the clock. One minute... 'What am I doing? There's no way this is going to be positive...' Two minutes... 'What if it's negative? Dear God, please let it be positive...' Three minutes... 'I don't want to look. I have to look...'

There they were. Two pink lines, a positive result, the answer was yes. I took a big breath, closed my eyes, and started to cry. I started to pray, and I thanked God a million times, over and over. I sat there for at least twenty minutes, periodically checking to see if there were still two pink lines. And then I went back to bed, trying to hide the fact that I was still shaking and crying.

I wasn't going to tell Joe until later that day, but he was awake, and the news came spilling out. I don't think either one of us could really believe it. We were overcome with joy. We laughed as we told our chocolate lab Macy that she was going to be a big sister.

Later that morning, we went to church, and it was so fun to have the secret between us. During a song or a prayer, we would intertwine our pinkies and wink at each other, and no one knew what was going on but the two (actually three) of us. Later that day, we went to the bookstore to buy a few pregnancy books, the Mayo Clinic Guide to a Healthy Pregnancy and The Belly Book, a nine-month journal for expectant moms, and then we hit up eCreamery for ice cream. When we got home, I begged Joe to take a picture of my newly pregnant tummy for the book even though, at that point, any changes in my "belly" were more likely to be from the ice cream than from our tiny little baby.

Over the next two weeks, we reveled in our secret. We didn't tell anyone in our family, not even when we went bowling for our nephew's birthday party. When we went out for dinner with my parents, we held hands under the table and periodically squeezed, which was mostly for me--I was the one struggling not to tell. At school, I had caved and told a few people. One of the people I told was an attending on my OB/GYN rotation. When I told her the news, she laughed at me and said, "Oh, so you have a gummi bear" (she thought that babies looked like little gummi bears at 5-6 weeks). "This must be a scary time for you to be pregnant" (meaning during my OB/GYN rotation).

Actually, fear was not really on my radar during these first few weeks of knowing about the pregnancy. I was learning about all of the different ways that miscarriages could happen, but my classmate on the Gyn-Surg service had promised me that he would scrub in for the D&C (dilation and curettage) cases if they presented in the ER (fortunately, none did). Besides, I was fairly convinced that the 'm' word wouldn't happen to me. It couldn't.

On the last day of my six week OB/GYN rotation, after the shelf exam, I went in for my "confirmation of pregnancy" appointment. I had picked an OB whom I had met during L&D. She came into the exam room and congratulated me--their test also showed that I was pregnant. We talked for a while, and then she told me that she wanted to do some additional blood tests. We would schedule my next appointment pending those results. Sounded good to me.

(What I'm listening to right now...)
 Various Artists Juno - Music from the Motion Picture