rivka | Aftereffects.

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Aftereffects.

Just talked to my midwife's assistant. I was a little confused about my discharge instructions from the hospital, which said to follow up with my midwife in two weeks. Originally she had told me that I'd be following up with a perinatologist (an OB who specializes in high-risk pregnancies) to monitor my hormones, because if this is trophoblastic disease it will be vitally important to know whether my pregnancy-hormone level goes all the way down to zero and stays there. (If it doesn't, it means that tumor cells implanted somewhere else and are continuing to grow.)

At the hospital, apparently, someone told Michael that my hormone levels were lower than they'd expect to see with trophoblastic disease, and that they were leaning more towards thinking it was a "blighted ovum" - a fertilized egg so chromosomally damaged that it was able to produce a placenta (and therefore pregnancy hormones and symptoms) but not an actual embryo. But that's not something they can actually diagnose until the path report comes back - which won't be for two full weeks, because (among other things, apparently) they have to do a chromosomal analysis.

So it turns out that we're going to be following a middle path. I don't need to go straight to a perinatologist, but I also can't just coast until my two-week follow-up at the midwife's. Instead my midwife will be ordering weekly hormone-level tests until we figure out what the hell this was all about. That seems reasonable to me. It's somewhat of a relief that they're not just slapping me onto the full trophoblastic protocol, and yet I also really really want to know what my hormone levels are doing.

I am in a lot more pain today, although it's nothing 800mg of ibuprofen can't handle. I now admit that yesterday I was being a macho, irrational, self-denying idiot. So today I didn't just stay home in the morning - I stayed home, resisted the urge to do "just a little" packing or cleaning, and laid on the couch for two and a half hours watching West Wing reruns. And I asked Michael to arrange his schedule so that he could drive me to and from work.

Emotionally I am coming along. I am sad but not completely prostrate with grief. However, I notice that I am banking a lot on being able to get pregnant again almost immediately, and I suspect that if that doesn't, or can't, happen then I will probably fall apart in a big way. And that might well be a problem.

If this is trophoblastic, standard medical advice is that we not even try to get pregnant for a year. Which would realistically mean that we'd wind up with kids who are five years apart or more, which... feels like a family with a big hole in the middle of it, where another kid should've been. Honestly, even a four-year gap seems like too much to me, except that that ship has clearly already sailed.

It's also the case that I'm almost 35. Even if we can start trying again right away - if it's a blighted ovum, for example - there's no guarantee that it wouldn't take a year or more for me to get pregnant. And I'm pretty sure that I wouldn't handle that well.

I think I will be able to cope with a baby deferred. I don't think I'll be able to cope with maybe-not-another-baby. Or a family with a big aching hole in the middle, instead of kids close enough to play together.

I also notice that I am channeling a lot more emotionally energy than I normally would to planning and organizing things for Alex. This seems reasonably healthy as long as I keep things under control practically and financially. But boy, have I ever been doing a lot of shopping for the perfect big-girl bed with the perfect accessories. And the best presents for her birthday, two months away. It's nice to be able to divert my energy towards the kid I actually have. It's nice to have a kid to divert my energy to.

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So today I didn't just stay home in the morning - I stayed home, resisted the urge to do "just a little" packing or cleaning, and laid on the couch for two and a half hours watching West Wing reruns. And I asked Michael to arrange his schedule so that he could drive me to and from work.

Oh good.

However, I notice that I am banking a lot on being able to get pregnant again almost immediately, and I suspect that if that doesn't, or can't, happen then I will probably fall apart in a big way. And that might well be a problem.

Ouch. Yes, it could. I hope it doesn't come to that.

It's nice to have a kid to divert my energy to.

Very, yes.

However, I notice that I am banking a lot on being able to get pregnant again almost immediately, and I suspect that if that doesn't, or can't, happen then I will probably fall apart in a big way.

I really, really, really understand this. My periods feel like they've never been further apart or less welcome. But I have a ton of confidence in your resiliency and humor to get you through this.

Oh gosh, I still remember my first big-girl bed, with bookshelves in it, and a space for a lamp and a clock, and rainbow sheets. What will Alex's be like?

We have a 4 yr, 9 month gap between our children. While I'd have liked to have less time in between, that's how it worked out, and now that we have the two of them, and the younger is 21 months, we see that they have a wonderful time together. They may not be close in age, but they completely adore each other and have a great time together. My mom and her sisters who are 4 and 11 years older than she are also extremely close and have been since day one as well.

I'm not discounting your feelings of wanting them closer; I completely understand. But if you do have a five year gap, it's not necessarily going to mean they're not close.

I'm glad you're taking care of yourself and getting some rest. I'm also hoping for good news on the health/diagnosis side of things for you.

Rivka, you are clearly not in a fit state to predict your future emotional reactions. You're still processing grief. If you have to live with only a loving husband and a wonderful child, which is the worst case scenari, you'll still have to"cope" with a lot less than most people. You'll do fine — believe you me. Once you are over this phase, a more realistic assessment of your life will come back to it. Jut focus on getting over the present and don't fret too much about the future, which is something you can't do much about now anyway.

it is a cast iron *bitch* not being able to do things on the schedule you'd planned on doing them on, she says, having just moved another housemate into the baby's room.

also, that's totally the cutest bed ever. i have a twin bed in the basement storage room, but it's in the famed french provincial ugly style. ew.

Glad you stayed home to take care of yourself.

I just wanted to chime in on the spacing issue... my sister and I are six years apart, which is kind of an interesting dynamic - growing up it was a little difficult to have such divergent interests (especially as I was entering teenagerhood and she still wanted to play with Barbies) but there were positives too - I'm a much better advice giver because I've had the benefit of lots of hindsight by the time she needs my advice. :) But mostly I wanted to say that I never, ever felt like we were missing a sibling between us. And we're very close now that we're a bit older.

Edited 2008-02-05 22:32 (UTC)

I'm glad you're resting and taking it easy! And that you're going to be able to get the blood tests to keep an eye on your hormone levels while waiting for the path results!

It makes total sense that you'd be banking on getting pregnant ASAP. I really hope that you can start trying soon and that things go well for you and you make Alex a big sister before too much time elapses.

Hugs and support to you.

It is really hard to come face to face with how little control we have sometimes over reproducing or building a family. I'm 37 and when I was growing up the pill was well established, and the message definitely was that babies come when you CHOOSE to have them. It's really hard that sometimes it doesn't work that way, and it is totally okay to grieve that.

But I am hoping that the results come back blighted ovum and you can get on the horse as soon as you like.

*continues praying, very hard, for your health*

Hoping for the best possible health news. And I'm glad you're at home. I couldn't believe you went to work yesterday. (There is more than a tinge of admiration in there, mind you.)

P.

In my vast anecdotal experience of grown ups, I think five years is a good sibling gap, often better than four.

At the very least you're going to need to have a few months of normal periods in between to get your body running smoothly for starting again. I think they say at least three months after a miscarriage.

The bed is adorable, and such a good idea. She'll love it. Incidentally, we still have the duvet cover we bought for Z's big boy's bed when he was three, and we sometimes use it, and we even sometimes use it for visitors. So don't get anything you'd be too embarrassed by in fifteen years time -- if we're not at all embarrassed by Noah's Ark, then I'm sure you won't be embarrassed by mermaids...

Good for you for staying home. The West Wing is better than chicken soup for curing what ails.

Whatever gap you end up with will be just fine. Sometimes a bigger gap leads to smoother sibling relations, even.

At 34, you're as old as I was when I had my FIRST child! You've got some time to sort this out.

I have that big gaping hole where kids should have been. My ex didn't want more than two children (that's not why he's the ex, but it was an issue for me). After

bridgeweaver and I were together for about a year, I miscarried at least once, possibly twice before I got pregnant and it stuck. There are 12 years between Shannon and Colin. The gap is just one of those things. Yes, I would have loved to have had more kids to fill that gap (with enough money and a big enough house, I would have been happy with a dozen kids--yes, I'm crazy).

Closeness in age doesn't mean the kids will play well together or even get along at all. Jackie (17) and Shannon (14) have a lot of ups and downs in their relationship. They squabble a lot, but when it comes down to it, they stick up for and protect each other from the rest of the world. Colin (2 weeks younger than Alex) thinks Shannon is the best thing EVER and she's pretty fond of him, too. My siblings (20 months younger and 4.5 years younger than me) and I are far from close as adults and we used to fight constantly as children. My parents set up my siblings and I to fight and not get along. I'm working to make sure that I don't do the same thing with my own kids. Each of my kids think one of the other ones is the favorite, so I think I'm pretty close. :)

I have one brother, who is 6 years younger than me. We always played together. We never had the big fights and fallings-out that I hear a lot of siblings closer in age have (and sometimes repair, sometimes not), and I think the age difference did play a part -- lack of direct competition, for example. While I was a teen-ager, my brother apparently was seriously hero-worshipping me (I was never a very girly girl, it has to be said) -- I didn't realise this at the time, but I learned it from later reports. We were always quite close until I moved to a different country, and even today (20 years later), we get along like a house on fire when we do meet.

I would not worry about a hole in the family. I can't say much for your other worries (except wish you all the best and hope with you that they come to nothing), but this one, you can put to rest.

(And hey, focusing on Alex sounds just like the best avoidance strategy I've heard of yet!)

I'm glad you stayed home.

FWIW, my brother and I are 3 yrs apart, we fought until I left for college, then we were friends, now we're friendly. My best friend and her sister are 5 yrs apart, they didn't fight much, and now they're very close.

I can relate to the worry over not being able to get pregnant again more than I can say.

I read the blog of a couple who had trophoblastic disease a couple years ago (and have since gone on to have a successful pregnancy), and their research led them to decide to start trying again after only three months of negative HCG tests. It's at http://additionproblems.blogspot.com. Most of the trophoblastic stuff is in the first couple months of the archives (March and April 2005), or I'm sure they would be willing to share what they know if you e-mail them.

Hang in there. It's not often you find yourself hoping for a blighted ovum, but my fingers are crossed for you.

Staying home and resting sounds like an excellent idea.

I'm not a parent, but from what I've seen, there are a lot of good spacings between siblings. I think my mother is closer to her younger sister (five years) than her older (20 months difference).

Resting when you feel bad is always a good idea.

My brother and I are 17 months apart and we've never been really close. We have very different personalities and as adults, well, I'm going to hell, you know.

The mermaids are adorable- I can see why you like them! Why not just show Alex pictures of both and let her choose?

I'm thinking of you and hoping that the big aching hole will get a little smaller and less achy. I don't think it's supposed to go away completely, but I don't think it will be this bad forever.

As to the bedding question, I will quote Betsy (kalmn) "embrace the power of AND!" :) Because really, how could you choose between those?

In terms of sibling distance, as I look at those I know and at my own siblings, I think personality really has more to do with it that age difference. There's only a bit over 2 years between my brother and sister, but they weren't close until high school. Now, they're drifting apart as my sister becomes my mother but yet pickier.

*sending best wishes for healing, body and soul*

I'm glad that the medicos haven't gone into panic mode. There re time s when 'more tests' is a good thing to hear.
My first three were 2 years and 3 months apart (twins after the first). I'm here to tell you that's too close. My next two came after a 10 year gap, with the youngest born when I was 42. My oldest is 15 years older than the youngest. I didn't plan it that way, but it's turned out beautifully. Older brothers and sisters give little ones different kinds of things and vice versa, and you can't predict which is better. In these days of small and short families, we forget that for much of recorded history, people had many brothers and sisters of all ages. If they all love each other that's enough. And from what I read, you and Michael model that very well. Choosing beds is good too

Emma

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gaps