Monday, February 23, 2015

The difference you make

                                           

I am 27 years old and in the last 6 months I have had the 2 worst days of my life.


We lost two babies. One at 9 weeks and one at 5 weeks. These children we have dreamed of for over 7 years. These babies we have planned for, we had waited for. These babies had names and they had toys, clothes, shoes and family. They had cousins and they had grandparents.

I've written about both my losses. I call it mine only because I wrote about MY loss. I feel the loss only for myself and understand it only as I know it, but many people lost these babies. My husband lost them equally. I know his loss did not just include them- but in losing them he lost parts of me, both times.

The pain of losing a child is not something we are familier with as a society. It is abstract. We don't talk a lot about it. It is something that is so easily kept private, possibly secret.

However there are those who deal with this frequently. Those in the health field who face this often enough to have a practiced face with it. I know this- I've been this. I've been the nurse placing an IV in a young girl who wanted nothing more then the baby she's only just found out no longer has a beating heart. I've been the nurse who discussed how much blood is too much blood. I've held your hand as you walked to the bathroom, weak from anesthesia as much as grief and still so afraid to see the toilet when you are done.

With my first miscarriage I was lucky. I had a midwife- who'd met me twice before. Her nurse greeted me with a knowing nod on my visit during our loss. My husband and I sat in a small waiting room, full of children and mothers. We waited for ten minutes but were not ignored for one. No one handed me papers about what I owed, no one asked me to fill out six forms about my plans for the baby had it lived. No one pretended to not know why I was there. It was written next to my name in the schedule book I'm sure: Madison B-pregnancy loss.

The nurse guided us back to a small room and the first thing she did was hug me. She took my vital signs and handed me a tissue.

The nurse drew my blood. She told me what I could expect. She guided me through it and gave me the warnings- when to call her, when to go to a hospital, what to do for pain, how much water I would need... She did this with a tempered voice that was calm, caring and not the least bit cold. She did her job quickly and efficiently but she did it with love.

The midwife came to the room and too talked to me, looked at my vital signs and told me to call for anything. She asked if I had any questions. She took my hand and said she was sorry. She spoke to my husband, understanding this was his child as well, that his heart was breaking too.

The nurse gave us her cell phone number, we could call or text if we had any questions. No matter what time or what question, we could call.

They gave me a note for work, because a miscarriage is hard, bloody and painful. Its long and violent at times and no one needs to work during it.



5 months -2 days later I lost another baby. The previous pregnancy still so fresh in my mind I had barely yet convinced myself I'd managed to create another life. I'd barely been able to bond with the child, only that day having the thought, "Its real, this is it. This is your child, give your heart to it."

Having lost our last pregnancy, a boy we named Josh, I'd made an appointment with a OB-GYN office nearby. Gritting my teeth against my ideas of modern obstetric care in hopes that by asking for high tech help I would up my chances of holding my baby this time.

I never even got to the first visit. Two weeks before the scheduled visit, I saw some blood on a tissue- this blood slowly increased in amount. Panicked and heartbroken I called to ask the office to see me soon, that I was bleeding and I needed to see a doctor.
The receptionist was kind cordial and got me an appointment for the next day just after noon.

My husband and I walked into a large waiting room. People spaced evenly throughout the seats, not speaking. All older, no children. I approached the window, a receptionist handed me a clip board with papers to fill out, said to bring it back with my insurance card and my drivers license.

The first paper; Name, age, phone number etc... Reason for this visit. I wrote "Miscarriage" on this line. My husband squeezed my leg. Taking those papers back I was handed a second stack. The receptionist took my first set of papers and set them aside. Then told me that with this second stack there would be originals and copies of each, the one with the signature line were to be returned to her and I could keep the others. Then she asked me if I'd chosen a pediatrician. I blankly stated no, so she handed me a list of local children's doctors.

The papers included a notice of cost- $4800 for vaginal or c-section, not including hospital costs, labs, ultrasounds, prescriptions or additional testing. Next was a notice that VBACS (vaginal birth after c section) were not supported in this group or the local hospitals. Page after page of this... lastly a triplicate form- healthy baby program by the state of florida. Asking questions regarding if I'd wanted this child, was it planned, how did I feel when I found out I was pregnant.

Ten more minutes later a nurse called me back to a small area. My husband tagged along, she told him to wait in the exam room while she took me to another area to get my vital signs and my weight. She sat me in a chair and placed a blood pressure cuff on my right arm, started the machine and asked, "what brings you here today?"

"I'm having a miscarriage" I said. "I've had one five months ago, I started bleeding two nights ago, but now I know it's happened."
Not a flinch, nor a groan, "Are you still bleeding now?"

The nurse typed my vitals and my response into her computer then said I could go to the room where she'd let my husband wait. We would wait for about ten more minutes.

A doctor came in, shook my hand. Told me to get undressed and sit on the exam table, she would be back in a minute, handing me a paper drape for my privacy.

She came back and told me to lay down, I asked my husband to come stand near me. With no romance or delicacy she proceeded to do an ultrasound. Pain ripped though my pelvis- but I'd expected that. My husband brushed my arm back and forth, giving me little squeezes on my shoulder while he watched the screen.

The physician said-"This is your uterus- the lining is very thick, but there is no longer a gestational sac. At this point it is a miscarriage. It is very early so you shouldn't need a D and C. We will send you to get a lab drawn to measure your pregnancy hormone. Most of the time this will show that the baby is gone, sometimes, but not often it will come back high and the pregnancy will continue even after bleeding.
I will have you get your labs drawn today and then again on Friday. You can take some Motrin for the pain."

She was kind enough to ask if I needed a pad. Said the nurse would bring it in in a moment.

I won't go on, I feel like I'm rambling, droning on and on. This appointment cost $225 dollars after insurance not including labs, and the most useful thing I got out of it was that my uterus looks like a sad face- thank you dear husband.

I left feeling worse then when I arrived, both emotionally and physically. My bleeding went from a steady heavy bleed to a downright gush. The intensity of my cramps went from a 4 to a 9. Furthermore I felt angry, and bitter and used. Clearly I was nothing but a account number to these people and my baby was nothing but a specimen. My husband needn't have existed as far as they were concerned.
In addition to this I felt misrepresented. I know a nurse has great power. With a single pause, a touch of a hand they can change the entire feeling of an appointment. It takes ten seconds longer to treat a patient like a human instead of a chart.

This was the difference a person can make. Not one person bothered a sorry, no hugs, no tears, no comfort.

This is the difference you can make in the worst day of a persons life. There is no poetry to the end of this post. There is only anger and bitterness. I hold my loss closely. So much more was lost that day then just the ideas of this one baby. The bulk of my hope to ever successfully carry a child was lost and it was not addressed.

I got a phone call days later that my labs were low enough, the baby was gone enough, that I didn't need to bother coming back.

Thank you to those who made my first loss such a thing of beauty, so full of love that I can look back on the first worst day of my life with a sense of loss but also of gratitude.

If you have the power to ease someones pain, you have the moral obligation to do so. Never forget that.









A Tale of Two Miscarriages

We did it again. We opened out hearts and let hope come in. We have been once again crushed.
At this point I am a few days past the worst parts and I am bitter. I am hurt and I am angry.

I was five weeks along this time. We'd only just found out. I'd only just that day told my co-workers. Telling them early was a protection plan, they would not give me violent or dangerous patients, they would not let me do heavy lifting, we were all together going to protect this baby.

We hadn't had a chance to tell family, it was too early. We didn't buy any baby clothes and I never got a good start on a baby blanket. I didn't get a chance to know this baby and I never will.

Beyond the obvious differences of this being such an early loss existed many more ways this miscarriage was different.

We were yet still struggling to find a OB or a Midwife. We were wanting a midwife but part of me wanted to check out from an OB first, as long as all was well I thought we'd go meet a midwife. In fact I had appointments scheduled for March 4th- the earliest anyone would see me.

October 16th: Both my husband and I got off from work at decent times. We came home to a nice easy meal and were poised to get to bed early. Shortly before turning off the lights I made the fated trip to the bathroom, where I was greeted by a small spot of blood. I, being the level headed girl I am, absolutely broke down. I cried, my husband fetched me my small baby blanket I'd made during my first pregnancy and held me. I kept saying, "I don't want to lose this baby too."

The next day I was due to work in a different job. I woke up to not much blood. I'd expected to wake up in a puddle frankly. I know spotting happens and I didn't have cramps so I tried to be positive. I clung to the monkey we bought Josh during Christmas and made my 50 minute drive to work. When I arrived I stopped to check- more blood now, darker, more sinister. My boss is a wonderful person, who not only allowed me to go home, but insisted I go home- relax, put my feet up and have bedrest. As a nurse she knew that sometimes bedrest alone can help.

But when I got home I'd begun to get small cramps and the blood continued to increase ever so slowly. When I say increase I mean it'd gone from a small pink spot on toilet paper to a angry red mark when I blotted.

My Joel came home. He called in a favor and got the day off. He came home and we cried. He made a fort. We watched Harry Potter. He reminded me of how much Josh brought us together, and all the good that came from a 9 week life. He said this wasn't the end and he told me we would be, forever, OK.

The OB office I had called allowed me to bump my appointment up to the next day. So with any hope draining with each hour, my love and I passes the day easily and tearfully. Being delicate and gentle and crossing our fingers for a chance at keeping out baby.




Thursday, February 5, 2015

Baby mind

Going into a pregnancy you get a lot of feedback. People want to help, they want to be a part of your journey. People offer a lot of knowledge and even more opinion. Despite this you may never feel entirely prepared for pregnancy, birth and certainly not for parenthood. Or so I assume.

Going into a miscarriage you are left with very little knowledge, and though you may find opinion eventually, there is a good chance that even that is not abundant at the moment. 

I was lucky. Our miscarriage was as lucky as they come. Which is a hard enough thing to admit.

We had our first appointment with our midwife, and opted to not have a ultrasound yet. It is not recommended at this time, not entirely necessary. The nurse took blood from me and we left with a sense of euphoria. 
A day later we received a message to call her back. My labs showed my HCG was low. They wanted us to come back for a re draw, we would come as soon as we could. We'd scheduled an appointment for a few days from then. 

My husband and I are nurses- it was then that we knew what was happening. 

We went to work the next night- a 12 hour night shift in critical care units. At 1:40 am I found blood in my underwear. Not a lot, but enough to just absolutely break me down. 

I ran down to my husbands unit, yelling behind me I was taking my lunch, grateful to have observant co-workers.

No words had to be said. The first words from his mouth were, "This is not your fault." That is my best friend- no pause, no thought, just honest comfort. We hugged for thirty minutes. I sobbed uncontrollably. People moved awkwardly around us in the break room- not sure if they should acknowledge my obvious breakdown or not.

Life got a bit fuzzy there. I remember someone prying when I went back to my unit that night... and I remember another nurse telling her to leave me alone and mind her business. 

I remember crying on the drive home, and barely swallowing a sandwich. 

I remember faking a smile while picking up the dog at the in-laws house.

Three hours of sleep before the midwife fit us in for an appointment.

When we told her about the blood she knew. Her eyes said, "there is no point in drawing this blood." 

Then she did the kindest thing she could have. She prepared me, us, for what was to come. She did not make me walk blindly into that darkness. 

She said it would hurt, that I should watch how much blood and when to call. She said it could last days, a week... come back if it starts to look infected.

We went home. 

My Joel- he went into best friend mode again. Pillows from the room, cushions from the couch, all the blankets in existence- they combined on the floor to make our fort. 
I mentioned before that he does this. When your heart is on the ground he makes that ground soft.

Hours past and the blood increased. Cramps became contractions and I went from sad, to panicked, to despondent and then finally, for a small period- I became present. 

I hit a wall. I couldn't handle the pain, or the reality of our loss. How was I supposed to mourn when all I could do was feel my physical pain? 

I went into the shower, I meditated and I cried. I immersed myself in my pain and I embraced it. 

It was 2 am September 20th 2014. That was when my sweet boy passed. 

Why am I writing this?
Because it is too often not spoken about. How are we as a society supposed to prepare, supposed to know how to handle this tragedy if no one ever talks about it? 


Why am I lucky? Not everyone has warning signs and small starts. I baby stepped my way through a miscarriage. Not everyone goes though the worst for only one night. And most importantly not everyone has a support system that would bring down Mid-Empire Rome just to make them smile.

I am lucky. And the truth is life goes on after you lose a big part of yourself and that kind of sucks. But eventually life moves on to a place where joy rebounds and pain dwindles and all that is left its the impression of love that a small life shared with you for a short time.

We are trying again and that is no easy feat when each time we dream of a baby there is a portion of that dream that still says- I had a baby.

I had a baby. And hopefully with any luck and enough glasses of wine I will again soon.