“Healed”

Healing. It’s a word we use frequently when talking about grief and I don’t particularly like it. My therapist pointed it out when she used the word and I stiffened. My issue with the word is that it connotes an end. We use it in medicine to talk about how someone gets better, and in a way this is applicable. As we move through our grief, we function better in society, we come to terms with the unchangeable fact that our babies are dead and we begin to find enjoyment and fulfillment in the world around us. But… and it’s a big but…in my medical world we declared someone healed- their uterus is back down to normal size, their stitches have dissolved and their milk has dried up- they are healed. In grief, there is no end. There aren’t even any concrete steps. Going back to work, holding babies, getting to the one year mark- these are things we do, but it’s not clean cut. When I went back to work, I shook, I cried, I took Ativan just to get through the door. Now I move fluidly through my day, rarely crying for my own situation. But there was no discrete time point when I went from being barely able to function to now. It was gradual and I still wouldn’t say I am in a great place. I recently came across this post and loved how he used the word adjusting to loss. A more apt term.

As Mabel’s one-year mark approaches, I think people have certain expectations. One year, I should be healed. I worry that expectations at work will change, that people will think somehow getting through the anniversary of my daughter’s birth and death somehow means something huge. That somehow the difference between February 15 and 16 will be significant, when really it’s just another day in the process. I remember reading early in my grieving this post (I can’t seem to link it directly.  click on http://glowinthewoods.com/  –> at the kitchen table –> scroll down to the post entitled “Tick Tock”) and taking away the message that it can take up to two years to integrate babyloss into your life. (I like how they used the word integrate and not “healed”). Two years! I thought. How am I going to survive two years!?! I thought I wanted to be healed right away, but now I can see I really just simply wanted to stop feeling the pain so acutely. Those early days were rough, weren’t they?

I still stiffen at the word “heal.” I think when those within the babyloss community use it, there is subtext. We know we are never healed from our children’s deaths, but it signifies we are functioning in the new world, the one without our babies. When those outside of our community use it, I can’t help but feel a little resentment, believing they think there is a true endpoint in our grief.

Where are you in your loss timeline? What do you think- are you healed? How do you feel about that word?

The first twenty-four

I’ve survived my first twenty-four hours in the hospital.  Great news!  Baby has behaved quite well.  I’m strapped into fetal monitoring bands pretty much twenty-four-seven.  I unhook myself to shower, grab some water, go for a quick walk.  I can take a longer break if I want, though I recognize that I am here for a purpose- monitor the baby.  The longer I’m off, there is technically more of a chance we could miss something (the whole reason I’m here).  So I’m tending to follow the rules.

We haven’t had any monitoring since 27 weeks and so it was hard for me to imagine what the baby would do.  If you put any pregnant woman on these monitors all day long, it’s quite common to see small dips in the baby’s heart rate and when that happens, as long as its not frequent or severe, baby is fine.   The dips usually resolve and baby goes on his/her merry way.  With no fluid, we would expect those dips to be more common.  They often happen when the baby squishes the umbilical cord with some movement or position change.  Most babies have lots of fluid to cushion and prevent compression of the cord.  My baby of course does not have that cushion.  But the first full day has gone well! No dips (at least that I’ve seen) and no one has come rushing into my room in response to the baby’s heart rate- all good signs.  I figured this weekend would be quite telling- either completely boring because baby has no dips or very exciting with nurses and doctors rushing in to help fix the heart rate.  I was hoping for boring and so far so good.

Though, since things are going so well, I almost feel a little guilty being here.  Baby is so good and I’m healthy, which of course makes me wonder if clinically we’ve done the right thing?  Should I be home, more active, preparing? Should I be working?  Should I not be worrying about it?

However, the truth is we would not have know how good this baby is until we did this- monitor monitor monitor.  And this great heart rate can change in an instance. If the baby’s heart rate drops and won’t come up despite all our tricks, best thing to do is deliver the baby- which here they can do in essentially minutes.

And frankly, some people might advise to deliver the baby just in case as 34 weeks- to prevent even the risk of that distress and emergent delivery.  We (those of us in obstetrics) often deliver people at 34 weeks for low fluid- but that ‘s usually for other reasons.  Most oligohydramnios is because either the water is broken or the placenta isn’t working.  When the water is broken, we wait until 34 weeks, then deliver because at that point the risk of infection is higher than the risk of prematurity.  With poor placental function, the risk of stillbirth is higher than the risk of prematurity.  So it makes sense in the common cases to deliver at 34 weeks.  My water’s not broken and my placenta is functioning fine.  And the risks of prematurity on my baby’s specific case is very high in our mind.  So we want those extra weeks, if baby can tolerate them, to grow the lungs and grow the kidneys.   But we also feel that if the baby had to be delivered due to distress,  at this point s/he has a reasonable chance of…. Surviving?…. of breathing?….. of doing something.

So really, it just feels weird to me to be so healthy myself, but in the hospital.  Something to really wrap my head around.  This is what we do for our children, right?  I rarely need vital signs. I need no IV.  I’m just here to grow the baby.  It’s all about the baby.  Brings me back to my post-CVS mantra- Stay Baby Stay.

Now that I have no agenda, I feel so much movement.  It’s true- being busy at work, I couldn’t tell if the baby was moving or not, so in the few minutes I might have to sit and be present with the baby, there might be nothing.  Which would of course get my anxiety going- has the baby died?  And I’d just have to wait.  Here, I know my baby is fine.  That burden of that anxiety has lifted.  Now I have my new challenges: adjust to hospital life, tethered within a few feet of a monitor; adjust to an open ended schedule (very un-like me.  I’m busy- it’s what I do best); adjust to sedentary life (with some yoga and hand weights exceptions); adjust to the idea of a baby that I will meet soon, in whatever health state s/he may be in.

I can’t believe I have something I can finally plan and hope for- I think I’m going to have a live baby.

Hello, hospital!

My world has changed.  I have waited, patiently, anxiously, for today to come.

 

Today I was admitted to the hospital.  It was a planned admission at 34 weeks, no rushing or scrambling. Yesterday one of the nurses at the high risk office called to tell me they would be saving a bed for me- and a nice big one at that, I realized when she told me the room number.  It was empty, meaning I didn’t have to wait for someone to be discharged, so I could basically go in at anytime.  I chose 11am.  Enough time to do something beforehand but not delaying too much.  Frankly, I wanted to go to one last bootcamp before my admission.  Bootcamp has really helped clear my head a bit and get really good exercise in my final trimester, something that has been a struggle to find.  And I knew I’d be limited in my activity while “in house” (medical speak for being in the hospital).

 

I was on the waitlist for the 830 class and luckily had a confirmed spot in the morning! So I got one last good sweat in and apparently got a good chuckle among the docs in the hospital during rounds.  The high risk nurse who booked my room had passed on how I had said I’d be in at 11 so I could try to go to bootcamp.  Glad I could entertain.

 

I was emotional just before going in- had a quick cry in the shower- but also eager to get there.  I just wanted to get settled and adjust to my new reality.

 

Going in to the hospital means my baby could be born any minute. It’ll likely be alive.  I know I’ve had many months to adjust to being pregnant, but I am still so far from really understanding what my new reality will be.

 

My journey has been a constant readjustment to new realities- some typical of any first timer, some unique.  In the beginning, I had the happy joy of adjusting to the positive pregnancy test.  That was easy and lasted a couple weeks.  Then I thought I was having a miscarriage and adjusted to the new timeline I would face before becoming a mom.  When we found a heartbeat a week later I got some of that initial joy back but had a lingering anxiety about miscarriage, which lasted the first trimester and I thought would resolve once I hit thirteen weeks.  The diagnosis of Down Syndrome came then.  I spent a long time working out how to just be pregnant and try not to worry about the associated problems (cardiac defects, bowel problems, risk for second trimester miscarriage and stillbirth) and how to envision my new life with a child with Down Syndrome.  And I did it.  I really did- I had a couple months where I was more pregnant than worried.  I was happy and proud to show off my growing belly.  I was happy to confirm with strangers, that yes I am pregnant, it’s my first, we don’t know gender and I’m due in march.  I felt only small pangs of anxiety, at times knowing I wasn’t letting myself have the full “world, look at me! I’m pregnant for the first time,” experience because I felt like I wasn’t telling the whole truth.  But excitement was my primary feeling.

 

The oligohydramnios changed everything.  I was then thrown into a world of- will my baby live or will s/he die?  We were given lots of depressing diagnoses and had hard decisions to make.  I felt like the substance of my pregnancy had been taken away.  Before I was planning for a baby- yes a baby with Down Syndrome, that may have some undiagnosed medical problems, but it was a baby.  Something concrete to plan for.  I could picture therapy appointments and changing diapers.  The risk of stillbirth was always in the back of my mind, but I was learning to deal with it.  The oligohydramnios and all that came with it took away that concreteness.  I really might have a stillbirth.  I may not have a baby that comes home.  And if there might not be a baby to take home, was I really pregnant?  Physically I was- there wasn’t much denying that.  But emotionally I haven’t been very pregnant.  It manifests in different ways.  Avoiding buying baby things.  Changing the conversation when people ask about my pregnancy.  Not envisioning a baby in my house.

 

So now I’m here, in the hospital, with at least one possibility removed.  I’ve spent many months fearing stillbirth, and now that I’m on continuous monitoring, that scenario is very unlikely.  Welcome to my new reality.  A baby is going to come out of me.  I have to get my head around that.  I might labor, I might have surgery.  It’s a tiny bit more concrete.  But since I haven’t really had the chance to absorb the reality that I am actually pregnant, I’m certainly not ready to give it up.  As much as I’m learning how hard it will be to be tethered to these monitors, I want to stay pregnant as long as I can.  I can see on the monitor that the baby is fine.  I want to cook and grow and nourish him/her as long as I can.  It’s got to be pretty warm and cozy inside my womb and I want to delay introducing my baby to the cold air and wires and ventilators.
The high risk doctor admitting me asked at the end of his visit, “is there anything we can do for you?”

 

Yes.  Keep me pregnant.

 

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