rivka

I can't believe it, but it's my day at home and Alex is actually napping. She never naps. I hope she isn't getting sick.

I'd love to say that I was celebrating her unexpected nap with some peaceful relaxation - but given that we're moving in two and a half weeks, there's not a chance. We're a little bit behind with the packing - and we're going into church budget season now, which consumes all of Michael's time. So I'm using her naptime to solicit estimates from moving companies, clean out and pack up the linen closet, run some statistics for Lydia, and cycle through a few loads of laundry.

Oh, and post to LJ. What would naptime be without LJ posts? I've almost forgotten, it's been so long.

We did, incidentally, get the lovely house next door to our current house. I'm very excited. All three of us are. They're doing some renovation work over there right now, so we haven't been able to get in, but I am gloating over all the lovely details in my mind's eye. The ones I remember, anyway. I'm finding that my memory is hazy on things like closet space.

Decluttering for the move is going well. We've taken two full carloads of stuff to Goodwill and thrown much more away, and I'm feeling resolute about not moving things we don't need. On the recommendation of fairoriana and juno I read It's All Too Much by Peter Walsh, and had a lightbulb moment: We shouldn't try to figure out where to put all of our things in the new house, we should try to figure out how we want to use each room of the new house, and then only move in the things that actually serve those purposes. Totally different emphasis.

I'm also realizing how much the clutter gets in the way of actual cleaning. I've always made a distinction between a messy house and a dirty house, but really it's the case that one leads to the other. You can't keep surfaces clean when they have piles of stuff on them.

( moving to-do list )

Seventeen days after my D&C, the pathology report is still not back. That's the bad news.

Fortunately, though, that's the only bad news. Based on the way my HCG (human chorionic gonadotropin, a.k.a. "pregnancy hormone") levels have been dropping like a stone, taken in context with the immediate experience of the D&C, my midwife is certain that what I had was a "blighted ovum" - a fertilized egg so messed-up that it made a placenta but wasn't able to grow or sustain an embryo.

My HCG level as of Friday was a stunning 33, down from 190 the Friday before. (I don't know what it was the night of the D&C.) We have high hopes that it will hit zero sometime this week. Then my body can go about the business of returning to its normal rhythms.

An exam showed that everything is getting back to normal: uterus and ovaries feel normal, cervix is closed, and there's physical evidence that the hormones are normalizing.

We can start trying to conceive again as soon as I've had a couple of normal cycles. If I get pregnant again, we'll monitor the pregnancy more intensely: HCG levels beginning at the positive test, progesterone levels, an ultrasound at 7 or 8 weeks. But there's no reason to believe that this would happen again. It was one of those random chances.

Needless to say, I'm still very very sad. (Wow was it hard to be back in my midwives' office.) But it's a big relief to know that there isn't anything horrible hanging over my head. There's no physical aftermath to a blighted ovum pregnancy. No long and frightening period of monitoring. We can just focus on the long, long job of picking up the pieces, emotionally.

So: sad, but thankful.

On Wednesday, someone from Mercy Hospital (where I had my D&C) called and left a message. She said that if I wanted to talk about my experience, she was there to listen. Yesterday's mail brought a sympathy card from the same person, who appears to be a nurse working in the pastoral care department. The card said that she was sorry for my loss and praying for me and my family daily. She hoped I was being kind to myself, and that I was being helped by support from family, friends, and God. She enclosed a little religious poem. (Not my flavor of religion (it's a Catholic hospital), but not offensive to me.)

It was nicely timed, I thought: two weeks after my miscarriage, a point at which an experienced counselor should be able to identify which patients are having a normal grief reaction and which ones are in real trouble. Also a likely point for someone with inadequate support to be feeling as if everyone's forgotten her loss.

Years ago I read a book about a woman who had a late second-trimester miscarriage. Afterward, none of the hospital staff - including her own OB - were willing to talk to her about what happened. They deflected her questions, avoided her eyes, refused to let her see the body. And my mother recently told me two stories. When she was a young married woman, my grandmother told her that she should never tell anyone she was pregnant until four months had passed - because that way, if it didn't work out and there was a miscarriage, no one would ever have to know. And a colleague of my mother's who also did maternal/child nursing once staffed a table on pregnancy loss at a community health fair. An 80-year-old woman came up and told my mother's colleague all the details of a miscarriage she'd had 60 years before. It was the first time she had ever told anyone at all. Sixty years later she was still burdened by her secret grief.

I am so grateful that it's not that way now.

Throughout this awful process I have been sustained by an incredible outpouring of love, support, and kindness. I've been stunned by the number of women who have quietly taken me aside to say that they too had a miscarriage, and that they know how terrible it is, and that I have their love and support. Instead of feeling alone, I've felt encircled by a large community of women, kind and gentle with me because they've shared this grief. Some of them are my age. Some of them are grandmothers or great-grandmothers. All of them survived, but none of them ever forgot.

I've also been sustained and upheld by all of you. It's touched me more than I can say to receive loving sympathy from my friends who are committedly childfree, as well as the ones who know what it's like to desperately want a child. To have people who barely know me refuse to walk away from the raw pain dripping all over my journal. To have repeated assurances of concern and support pour in again and again when even I have begun to be exhausted by my own neediness. To get presents in the mail: cookies, chocolates, more chocolates, an unpublished novel draft, a mix CD, cards with messages of love. It's been so much. It's helped so much.

I still feel sad and fragile, and I expect that I will for quite some time. But I also feel loved and cared-for. I'm pretty sure I'll be okay. For which: thank you.

I just got an e-mail through Flickr, which purports to be from an employee of the Flemish Ministry for Education and Training. In Belgium.

Dear Ms,

I'm asking you this question on behalf of the Ministry of
Education and Training, in Flanders, Belgium, Europe.

Could I use one of the photo's you posted on flickr.com -
e.g.

http://www.flickr.com/photos/rivka/540584772/

or a similar photo - on our nursery education website at

www.onderwijs.vlaanderen.be/jaarvandekleuter ?

Many thanks in advance.

Best regards,
Luc Stoops
Flemish Ministry for Education and Training
Brussels,Belgium, Europe
luc.stoops@ond.vlaanderen.be

Huh.

Any reason why I shouldn't give my okay? I can't imagine a more innocuous, share-able picture.

Grief is kicking my ass today.

We went grocery shopping for the first time in two weeks. At the milk cooler, Alex was hopping around being helpful.

"Mom, do you need your yellow milk?" (Milk in the yellow carton is low-fat. She drinks whole milk, in the red carton.)

"No, I'm not going to buy any." I hate milk. I only consume it when I'm pregnant and need the extra calcium.

"But you don't have any yellow milk at home."

"I know. I'm not going to have any milk for a while."

We turn away from the case. She's still not done. "Mom, you drink special milk, right?"

Yes. When I was pregnant, I drank "special" low-fat milk that was just for me, not for underweight toddlers. I'm not pregnant now. I won't be buying any more low-fat milk unless I get pregnant again. Okay? We're not buying milk in the yellow carton BECAUSE THE BABY DIED.

I didn't say any of that. I just sent her off to the deli with Michael. And had the two of them play Letter Searchers in the check-out line so she wouldn't notice me crying.

OMG grief is just kicking my ass today.

Not when accepting sympathy from horrified people who've just found out.

Not when explaining to Alex again that there isn't a baby.

Not even when sorting and packing up some baby clothes for the move.

But without warning, this morning, while waiting for the elevator to take me to the hospital blood lab for a quantitative HCG follow-up, I completely lost my composure and started to cry. Half an hour later, I'm still feeling incredibly fragile. No idea why.

I would feel less broken right now if my reactions were easier to understand. In a way, it would make more sense if I were crying all day or unable to get out of bed. Instead, 90% of the time I feel totally normal and functional. And then: not.

The other thing that set me off without warning was hearing my father-in-law's voice, when we called him to make sure they'd escaped the tornadoes that slammed through Memphis on Tuesday.

Until recently, I had never really thought about the fact that the reason Michael was adopted is that his mother had several miscarriages, ultimately ending in a hysterectomy. Michael's father has never said a word to me about it. But somehow the kindness in his voice when he says "Hi, honey" connects me to this pain of his, more than forty years old but still present.

Michael's father is aware of, and solicitous of, Michael's pain and grief in a way that no one else seems to be. (I love Michael dearly, but I am ashamed to say that my grief is pretty self-centered right now.) I'm so glad that there is someone who sees his primary job as taking care of Michael. And yet what an awful, awful connection for a father and son to share.

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.

Saturday morning, Michael brought Alex up to our bedroom and the two of them climbed in bed with me. She noticed my hospital bracelets right away.

"What's that?"

"That was a bracelet from the hospital. I got very sick yesterday and had to go to the hospital so doctors could take care of me. They put the bracelet on me so that everyone would know who I was."

"Did you ride in a fire truck?"

"You mean an ambulance? No. Papa drove me in the car."

"If you're sick you should ride in an ambulance," she informed me.

She asked some questions about whether different parts of my body hurt. "...What hurts, then?"

"My tummy hurts." I took a deep breath, realizing that this was the time to explain. "Do you remember that we said a baby was growing in a special place in my tummy? There is not going to be a baby. We thought a baby was growing there, but Mama was just sick. I hurt in the place where the baby was supposed to grow. Maybe someday a baby will grow there, but not for a long long time. So that's very sad."

Alex made a little sad noise.

"I know," I said. Michael and I put our arms around her. "We're all sad that there isn't going to be a baby."

"Mama, do you feel better?" she asked.

"I'm a little better, but I'm still sick. I need to rest and lie down a lot today, and I can't pick you up or have you climb on me. In a few days I'll be better."

We set up a signal: I would keep wearing my hospital bracelets to remind her to be gentle with me. When the bracelets came off, it would mean that I could pick her up again.

A couple of hours later, she looked up from playing. "There's not going to be a baby for a long long time?"

"That's right," I said. "Maybe someday, though."

I sent her and Michael off to church by themselves this morning. She turned around at the door and looked earnestly at me. "Mom, get lots and lots of rest."

"Okay, honey. I will."

---

I thought I would never ever post song lyrics in my journal, but I've had a Meg Barnhouse song on repeat play for the past three days, and it's helping more than I imagined a song possibly could. It's a conversation between her and Julian of Norwich.

( lyrics below )

I'm home. I'm reasonably well.

I know that tomorrow I will be grieving and sad again, but right now I am so profoundly relieved. It got really scary there for a while.

Thank you all, so much, for your support. It means more than you could possibly know.

Still home. Waiting for the midwife to call back.

( disturbing material, as usual )