G3

In the OBGYN world we describe a woman’s pregnancy history in terms of G’s and P’s.  There is an alpha numeric code that tells the story- “GTPAL.”

G stands for gravida. It’s the number of times a woman has physically been pregnant.

T is for term- the number of term pregnancies a woman has had.  Any baby born at 37weeks or after counts here.

P is for preterm births, those babies born after 20 weeks but before 37 weeks.

A is for abortion. This is a medical term, not a political one.  Medically we call any end of pregnancy before 20 weeks an abortion.  It may be spontaneous, aka a miscarriage. It may be elective, aka a termination.  A also includes ectopic pregnancies.

L is for living children.  No further explanation needed.

To make it even more confusing we shorten the the GTPAL to G_P_ _ _ _.  In this instance G still stands for gravida and P stands for para- para meaning the number of births (term or preterm). It might be better to explain by example:

A woman who has had one term living child with no other pregnancies would be a G1P1001 versus a woman who has had one living preterm child would be a G1P0101 versus a woman who has had one miscarriage and no other pregnancies would be a G1P0010.

It can be used to describe a pregnant woman too.  My friend who is pregnant for the first time is expecting twins.  She is currently a G1P0000.  When she has the babies, if she has them at term (fingers crossed) she would be a G1P1002.

Make sense?

So why does this matter?

As of late, I have recently added a new G to my history.

After Mabel I became a G1P0100.

After Felix I became a G2P1101.

I am now a G3P1111.

My loss story continues.  I’m having a very early miscarriage.  So early I barely became attached. But it has still stolen the breath out of me.  Did I take five pregnancy tests just to be sure? Did I figure out my due date? Sure did. Think about maternity leave? Toss around baby names in my mind? Imagine telling Felix he’d be a big brother? Dream of a living sibling for me son? Did I get excited? You bet. So when it turned out to be just a shadow of a pregnancy, a whisper of something I’ve been wanting and trying for since Felix was born, I grieved. I am still grieving. I feel broken in so many ways, untrusting of my body, unsure of my ability to be happy.  I know I will find my way out of this darkness- I have crawled out of deeper holes.  But in the meantime, I will mourn my little whisper…

 

 

Good Bye, Paul

My friend Paul died this week. To be honest, I was not very close to Paul. I probably haven’t spoken to him in ten years, but social media has kept me connected in that voyeuristic kind of way and I have followed his story the past couple years. His death has hit me hard for such a long ago friend and it has ripped me open a bit.

I first met Paul, or Pubby, as he was introduced by his long-standing family nickname, at a summer camp I worked at during my college summers. It was an alumni family camp for my university- staffed by current college students. Job positions were competitive- hundreds applied for sixty spots and those accepted were often known for their creativity and outgoing nature. The fun from those summers spilled into the school year as well, as my new group of incredibly bonded friends reunited on campus. It was like Dirty Dancing- but wilder and more fun- skinny-dipping, costumes, secret parties. Once I became “Staph” I joined a community of welcoming, free spirited people to whom I was always bonded, for years to come. I became instant friends with Staph from years past, even if we never worked together, simply because they were part of the community. I think Paul and I overlapped one summer there- he was a few years older- but I do remember he was a bit of a legend, as many of the older Staph were. I even kissed him once at a party, because that’s the kind of place it was- kisses were given out rather freely. I often told friends that little tidbit, because I was just so proud that I once kissed someone like Paul.

When went to midwifery school, I was accepted to a good program in a city in CT, I arrived at the school with my tiny car (one of those new VW Beetles) packed with all my earthly belongings. I came site unseen. I had interviewed over the phone and had only driven through the city on the highway, remembering the reputation it had as being a dangerous place. I left my car parked on the street and walked timidly around the med school campus trying to find the dorm I would be staying in. I was terrified- I didn’t know anyone or anything about the place. I thought my car would be broken into. And as I found the dorm and was walking up the path, I spotted a familiar person sitting on the lawn outside. “Pubby!” I walked excitedly to him and was greeted with a hug. He was in med school there and having lunch with another med school classmate (also former Staph, no less). He was such a warm welcome on my eyes, and my fear of this scary city began to fade- because I knew someone, someone nice and cool and welcoming there. He made my first day ok.

Throughout those years I saw him on and off, mostly in group settings, though I remember having dinner with him and his then girlfriend, now wife, Lucy- and I always still felt that sense of awe for being friends with someone like Paul. I guess I felt like he was out of my league in a way. He never made me feel that way- it’s just that he was so smart and funny and simply just cool. He and Lucy moved away to California for residency and I stayed behind in that fearful city I grew to love. I kept tabs, like everyone does these days- through facebook mostly. That’s how I learned of his illness. He was at the end of his neurosurgery (yes, brain surgery- he was that smart) residency when he was diagnosed with lung cancer. Lung cancer. A non-smoking physician in his mid 30s. What? He was a rarity. He continued to practice and wrote a lot about his unique diagnosis and how it affected his thoughts on the world, on medicine. His words and his story were fascinating, coming at a time when I needed to hear them. I didn’t talk to Paul directly during this time- just occasional messages on his health update blog, but I followed his publications. His wife even reached out to me while I was pregnant and while I was grieving and we corresponded a bit.

When I was pregnant with Mabel, he wrote this piece, which struck me. The uncertainty of prognosis. Here’s someone like Mabel- diagnosed with a rare disease, so unlikely. No real prognosis can be given. He understands that. But look! He’s living, beating the “odds.” Paul’s diagnosis and continued life gave me hope for my baby. And then my baby died; she didn’t beat the odds, but not everyone can. But Paul was doing it. When he and his wife announced their pregnancy after Mabel died, I didn’t cringe in the way I normally did when others announced such things. I actually thought, “good for them.” Maybe a little part of me was envious because I thought Paul would live- but they understood struggle, so it was ok.

I can’t believe he’s dead. He was young and fighting a rare disease. He wrote about his struggles so prolifically, beautifully, thoughtfully- I thought perhaps writing the words themselves could somehow stave off what apparently was inevitable.

My facebook feed is filling up with photos of Paul and his articles. My first instinct is that I want to look away- it is just too sad. But I don’t. Because I know Lucy can’t look away. I couldn’t look away in the early days after Mabel’s death and I envied those who could just go about their normal lives without the heavy burden of loss. They could feel sad on their own time, while I was trapped in a prison of grief- hard enough to simply be there, but worse to be there alone. It reminds me of when people say “I can’t imagine what you’re going through…” The thing is, I can imagine it. I don’t know what she is going through- my husband has never been diagnosed with a terminal illness, never died. But I can imagine it. I can imagine the sorrow and it’s terrifying. I have actually imagined losing my husband- because that’s what the death of a loved one does- it made me worry about losing anyone close to me.

Lucy announced that Paul passed away with their baby daughter resting on his chest.   The imagine… it’s the mirror image of my loss last year. My baby resting on my chest as she ceased to breathe. Paul’s daughter resting on his chest as he ceased to breathe. So beautiful. And so so wrong too. Babies aren’t supposed to die and babies’ dads aren’t supposed to die.

I am so angry at the injustice. This post is about Paul, about Lucy, about their baby. But clearly it is about me too. I wanted to write an unselfish tribute to this man, who touched so many lives both before and after he got sick and I hope some of that came through. He wasn’t supposed to die.

I think of Lucy, and her family of three- though one is now here only in memory and I think of myself and my family of three, though one is now here only in memory. Paul will forever be tied in my mind to Mabel because their stories are so different, but also so similar. Good bye, Paul. I wish you were here.

one of his most recent pieces….

http://stanmed.stanford.edu/2015spring/before-i-go.html

An interview years ago… (scroll down to the “His Girl Lucy” section.  so worth it, I promise)

http://www.thequietquiet.com/archives/doctor_paul.html

 

Grieving parenthood

As I slowly continue to work my way through this article, I keep finding little points, where I’m nodding my head. “Yes, yes.” I say in my head as I read. It’s incredibly validating. One section keeps reverberating through my head. For some of us, we lost our first pregnancies, which in addition to mourning the loss of our child, we are also mourning the loss of transition into parenthood. Into a new stage of life.

 Especially when it is the first pregnancy or when there are multiple pregnancy losses, there may be developmental interference rather than progression. Internal stagnation is common. Women and their partners experiencing pregnancy loss often talk of not getting on with their life goals, plans, and dreams. They feel stuck, off track, as if they are running in place as life is passing them by. Erikson’s landmark delineation of the eight stages of human development emphasizes the crucial role of generativity, serving as mentor to the next generation, which is typically, though not inevitably, realized in parenthoood.104 A qualitative study of the elderly suggested that lingering grief for their pregnancies of decades ago, and perinatal losses, may be related to their not having any grandchildren, failing to take one’s place in the generational hierarchy.

And that grief is real too.

Many of the usual responses to perinatal loss, such as visualizing or hearing a baby, wishing to have another baby as soon as possible, and feeling intense pain and envy when exposed to other babies, may sometimes be based less on grieving the death of their particular child than on confronting the painful frustration of not being able to parent.

This last line especially speaks to me. I don’t have to justify how sad I am about losing Mabel- losing her as a person. But I want to scream that I am also so sad … SO SAD… that I lost the opportunity to parent. Just like the article says, it hurts watching others with babies, not just because the babies make me think of Mabel, but also watching others parent their children in a way I don’t get to do! I’m so angry about the unfairness of that. I don’t get to see if I can comfort my crying baby, if I’ll struggle with breastfeeding, if I’ll be miserable and sleep deprived. I don’t get to see if I even enjoy parenting. I simply want the opportunity to do so and I have such little control over it.

I know I’m still a mother, a parent- I don’t need reassurance with that. I just wish I could have the chance to be a more traditional mother and parent in an active may, not simply tending a grave and making sure my baby’s name is not forgotten. I am not only grieving my daughter, but I am also grieving the loss of parenthood.

Do you feel this loss as well?

Sunday Synopsis

When a child dies and another is born… I don’t like this article.  I feel like it is almost critical of those who want to have a child after loss.  Granted, I am reading this from a babyloss perspective and not the perspective of a subsequent child after loss.  Personally I think it’s demeaning- as if we all just figure another child would replace the one(s) we’d lost. Newflash: Mabel had Down Syndrome and multiple medical complications- no one could replace her.  Her condition was one in a million.  Even if she was healthy, she was her own person.  I’ve always wanted several kids (a desire I had taken for granted) and if I choose/am lucky enough to have more, I hope people don’t judge me.

EIght tips to help someone grieving through the holidays: a nice article. do you have any other tips to add?

Lessons from the stage: The term “yes, but…” is avoided in good improv for good reason- it kills the story.  It is strikingly similar to the “at least” we often hear in loss.  I’m going to try to be more conscious of this term now too.

Day 8: Resource

I walked into a Hope After Loss (formerly Hygeia) support group meeting ten days after Mabel died.  I paused in the hallway outside the door, crying and holding Chris’s hand.  I knew I needed to go in, but I cried out of fear and sadness.  I sat on the couch that first meeting and got to tell my story from the beginning.  Several meetings later I found myself among a group of women who became friends, some of who I check in with almost daily.  At a meeting a month later, one looked at me and said, “it’s good to see you smiling,” as I walked in.  Only in that place, among those people, would I have welcomed such a comment.  Anywhere else, I would have felt guilty or the need to explain that despite my momentary smile, I was still very very sad.  But not there.

This past weekend we walked in Hoe After Loss’s annual Footprints on Our Hearts walk, where I was the third highest individual fundraiser (thanks to many of you!).  I was joined by many friends, the babylost and not, surrounded by love and support on a day to remember Mabel and all babies gone too soon.

#CaptureYourGrief

HAL HAL2

A fairytale

Once upon a time in a land far away, a group of children played outside in the warm spring air.  Suddenly, a dark cloud appeared out of nowhere and sent a storm of heavy, cold rain, drenching the kids.  They all scattered, running breathlessly for cover.  A loud crack and flash of light filled the air and the storm passed as quickly as it had sprung.  When everyone wiped the rain from their eyes, they saw their playmate standing burnt in a smoky haze.  Of all the children running wildly about, she had been the only one hit.  Lightening struck and left her dazed, with her own personal storm cloud above her head.

She didn’t run fast enough.

It’s because she didn’t eat her vegetables before her desert.

God wouldn’t give her more than she could handle.

They all said, thankful it wasn’t themselves who were hit.

Rain poured constantly down on her from the dark cloud that followed her like a lost puppy.  No one wanted to play tag with her; no one invited her to picnics; no one shared their lunch with her, for fear of getting wet.  Cloaked in their own invincibility, they enjoyed their dry warmth and looked at her with pity and fear.  They didn’t want her cooties.

When storm after storm passed and no other child was hit, they soon forgot about her, with her rain-drenched hair and water-wrinkled fingertips.  So the little girl packed her things and walked far far away, leaving all her playmates in blissful ignorance.

Not every fairytale has a happy ending.

I know how the story is supposed to go : A period of hot sunny days that parched the earth and began to dry up all the beauty.  Flowers died, trees withered, grass browned.  At night the little girl walked through the fields sprinkling her rain over all the thirsty plants.  They grew and blossomed.  When the kids woke in the morning, they had no idea that their land almost soured.  To them it was everyday beauty; they took it for granted.  Only the little girl could see just how beautiful it was.  It took the contrast, her living under a raincloud, to see how beautiful the sun was and how it made everything around her grow.  She still lived under that rain cloud, but now she understood.

That’s how my book is supposed to end.  I love the idea of writing a book, but a book needs an ending and I haven’t figured it out yet. There has to be something uplifting to make the reader feel good.  I have my moments of optimism, but I have not come out of the storm yet.  Once I can claw my way out and live in the sunshine again, then I”ll have my story.

How do some people figure it out?

It’s like it never happened, like she never was here.  I see one patient after another and we talk of their exercise routine.  I ask about their sex life.  We discuss their vaginal discharge.  I am transported back to a year ago, when I was actually pregnant, but didn’t know it yet.  My life hadn’t changed.  I went to work each day and helped women figure out their birth control and navigate through abnormal pap smears.  Fastforward to right now and when I’m at work, and it is the same.  There is a sign with my daughter’s photo and her life summed up in a short paragraph, but otherwise, no difference.  I sit across from these women and for a moment I am distracted, thinking of their lives instead of mine.  They don’t ask, because the visit is about them (as it should be).

At lunch time I say to one of my nurses who has been especially helpful in the past few months, “maybe I should take the sign down?”  She asks why.  “Because no one says anything, so it feels a little pointless.”  We decide to keep it up longer, at least until I start seeing OB patients.

Then I am seeing my last patient of the day- a young woman who I have never met before.  As we say our introductions and I ask how I can help her, she pauses and says, “I just want to express my condolences…” and says a few more kind words.  She read the sign.  I was so resigned to the fact that though my daughter’s absence is a constant presence for me, it might not belong in the workplace that I became a little teary eyed when she spoke her words.

I raised my eyes from her chart and looked at her.  “You are the first person to say something all day.  Thank you.  That is so kind.”

I know people don’t know see the sign.  Others don’t what to say and I don’t blame them.  I used to not know either.  But then every now and then I have an interaction like this one.  It amazes me how some people can figure it out.  Is it something they are born with, this deep-rooted compassion and fearlessness to say something?  Was it taught to her as a child, raised by parents who showed her the grace in saying something, anything?  Has she learned her empathy the hard way, having lost something or someone she loved?