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March 2005

Why I Will Have A Headache Tomorrow

Do you think it is odd that I keep having largish dinner parties wished upon me? Some are born to dinner guests, some achieve dinner guests, and others have dinner guests thrust upon them.

I suppose I am still just a girl who cain’t say no.

On Tuesday Steve’s cousin Holly (you remember- pretty, nice Holly whose lovely young husband died last summer) left a message saying that she was coming to Minnesota on Thursday and would like to stay with us for the night. Delightful, we said. And, she added, remember when we said that we would like to have her Minnesota friends over for dinner sometime? Wouldn’t Thursday be great?

So I am expecting somewhere between 9 and 15 people for dinner tonight. Surprise!

It will be fun (I hope) and it was just the thing, actually, to shake me from my funk. Sorrow be damned, there are bathrooms to clean! And oh sweet crabapples, cat hair to corral. You would expect these cats to be bald by this point, I swear. How can there be any fur left upon their sleekit bodies when the stuff gathers on the couch by the bushel? Stupid shedding cats.

But back to my dinner… I made the dessert on Tuesday (an old Fine Cooking standby that combines cheesecake and something fudge-like into a nice make-ahead wheel of goodness.) Yesterday I put together two salad dressings, bought a case each of wine and champagne, and assiduously ironed my napkins and placemats. As I still don’t know how many people are coming I decided to just make some spicy shrimp pasta (see recipe, bottom right.) I figure I can just keep adding shrimp and linguine to the pot as they roll in the door. Eeeee-zzzzzzz. Salad, bread, some cheeses… done. Besides, did I mention the champagne? That’s the whole party right there.

Although while I am thinking about it, how much pasta do you think, per person? Let’s say we get 12 (plus three little kids), what do you think, three pounds of linguine and two pounds of shrimp?

I am embarrassed to admit this but I am surprisingly nervous. I am REALLY REALLY REALLY shy (no, really) and I haven’t met most of these people. What if I am weird and awkward and everybody shuns me? And then there is the pressure of feeding them at a reasonable hour and hoping nothing tastes gross…

Not earth-shattering problems I know, but we all have our worries. Lemme know about the food quantities, if you have a second. Also, if you would like to reassure me that everybody will like me and the pasta will turn out fine and it is okay if we set up a card table at the end of our real table that would be nice too. WHAT a relief that the table is always set for a formal ten… (Hi Mollie!)


It's 6:22. Do You Know Where Your Child Is?

It is possible (although, let's be honest, not bloody likely) that Patrick woke up this morning at 5:20 for some reason other than the fact that Steve left his (Ed. -his meaning Patrick's) bedroom light on all night. Whether he was merely exhibiting a vagary of toddlerhood by waking up two hours early or, as I assert, was the victim of half-assed and neglectful bedtime parenting is beside the point, what matters is that he did indeed wake up at 5:20 and he notified me of this fact by screaming at the top of his lungs. This caused me to bolt upright from a dead sleep and run upstairs, where I found him sitting in a bedroom so flooded with light it could have been situated on the surface of the sun.

"Whoa," I said, shielding my eyes.

And the poorly fathered baby whimpered and put his arms up and said, "Go sleep in the guest bed with Mommy?" and I said, "Uh-huh" and hauled him and Bear down the hall to the guest bedroom.

I was tricked, of course. By the time I drug the coverless duvet over from the window seat and got the three of us nicely snuggled on the mattress pad (apparently I moved the sheets and pillow cases to the laundry room yesterday- how efficient I am!) Patrick was wide-awake.

"It's a bright sunny morning," he chirped, pointing out the window at a gray, fish-fingered dawn.

"No, no," I whispered, "it is not morning yet. Go to sleep."

"OH! 5 2 5!" he said, looking at the digital clock.

"Shhhhhhhh."

Silence.

"5 2 6!" bleated Patrick

"Yes," I mumbled, "it is 5:26. But morning doesn't start until 7:00, ok? When the clock says seven oh oh we can get up."

"5 2 7! 5 2 8! Look Mommy! It's a nine now! What do nine and nine make? Bear needs to be under the blanket! It's a bright sunny morning! That's your nose. That's Bear's nose! Five three oh! Fifty three! Thirty! Oh! We have to wait. Wait until seven oh oh. Where's Daddy? 5 3 1! Mommy it is five three one now..."

And so on, and on, until 7:00, when we went downstairs. And discovered Steve in his office, drinking tea and looking breakfast-ed.

He looked surprised. "Were you upstairs? I've been up since 5:45, for some reason. I couldn't sleep any more. I got in the hot tub. Very relaxing."

"Five forty five!" agreed Patrick.

I dropped the child on his lap. And I went to my own bed- all alone. And slept until nine.

It was divine.


Sad

I am having a hard time.

Physically, this has been one of the worst miscarriages I have ever had. More bleeding, more cramping, more infected-veinedness than usual. I feel gross and sore and my ass still has lumps from the progesterone shots. I think they will be around forever, the only lingering testament to what $20K buys you these days.

I just hurt. I have counted my blessings until my fingers bled but I cannot seem to talk myself out of feeling sad. YES I love Patrick. YES Steve is... well, I adore Steve. YES I am grateful that we are all healthy. YES I like the new Persian rug and drinking wine and it will be nice to have the basement done but... none of these things are getting me out of bed in the morning.

OK. Something is obviously getting me out of bed. As far as the kitchen at any rate (hey, I added some recipes for you. more coming.) Habit is pushing me along, I guess. Responsibilities. But I feel leaden and poky and... sad. I didn't make an Easter basket for Patrick and I feel guilty about it. I will go to communist playgroup tomorrow but I will be sullen.

In the past my war-cry has always been: Never Again! Next Time We'll Try IVF!

Now I have no war-cry. I have no clear plan, no ace to throw that fate cannot fucking trump again.

I doubt my epitaph will read:

Here Lies Julia, She Failed to Have Second Child and Consequently Stayed Sad Forever

but there is a lot of ground to cover between beginning to doubt another baby is our future and learning to live with that fact.

So. I am sad.


A Very Good Friday To You

I am officially bored to tears with describing my each and every blood cell (red white or blue) so suffice it to say: I am fine. I will live.

The cats might be in trouble, though. Patrick is currently clutching a family-sized chocolate ice cream bucket and chasing mostly-blind Kelvin around the first floor. From the fiendish gleam in Pack's eye I can only surmise that the goal is to trap the cat under the bucket. I would intervene but they are obviously enjoying themselves. The cat, if it is any indication, keeps stopping to let Patrick catch up with him. Besides, I am working. Working on the blog. Keeping the household in blog hits. Very important.

Speaking of family-sized chocolate ice cream buckets, I just made a rather humiliating discovery. I just realized that I have been telling people that Steve finishes a five gallon tub of chocolate icecream every week, winter or summer. And when they say, "Five GALLONS? Really?" I nod and swear that this is true, true, true. But as I made a half-hearted attempt to take the bucket away from Patrick a few minutes ago I noted that it is actually only five quarts. Steve eats five quarts of chocolate icecream a week. When I went in to report my long-standing error to Steve he laughed at me (rather more heartily than necessary) and took me down to the basement to show me a five gallon bucket of ceiling paint. And you know what? That would be a whole fucking lot of icecream.

Patrick failed to nap the other day and after an extended period of time I finally admitted defeat and went to free him. When I walked in I was immediately struck by the party atmosphere that prevailed. One of his blankets was on a lamp. Bear was dangling from the corner of the changing table. A book that had been in the crib with him had been reduced to confetti. Patrick stood in the middle of his bed, sockless, with one arm hanging out from underneath his shirt.

"What the...?" I asked.

Patrick turned to face the same direction I was facing and put his hands on his hips as he looked around the room. "What the hell is going on in hee-or?" he asked.   

This is actually a fairly old trick- blending into the crowd and pretending to be a bystander. I believe that arsonists do it all the time. However, in this case the trick failed because I am very smart and Patrick was the only one in the room. A simple Locked Door mystery, really.

J'accuse, Patrick.

The real question is: where did he learn to swear? We do not own a parrot formerly of his majesty's navy. I can only blame communist playgroup. When everyone is allowed to join it stands to reason you are going to get all sorts.

What? You think it was me, don't you? You think there has been a time when I have actually uttered the phrase 'what the hell' in the presence of my little blue-eyed sponge.

Hmmph.

For no apparent reason yesterday I asked Patrick how one spells "puppy." He thought for a moment and said P-O-P-P-E.

We were incredibly impressed.

Then I asked him if he knew how to spell "cat."

"C," he said.

"Yes," I prompted while programming Harvard into the phone.

"Q-M." He finished proudly.

Huh. I guess my mom can go back on speed-dial.


Infection To Insult To Injury

OH MY GOD! Enough!

My ARM is infected. RIGHT THERE. About a quarter inch up from where they wedged the damned IV into my wrist. See the big reddish blotch? Note how warm the skin is there? Observe the menancing way it appears to be creeping up towards my shoulder?

Do you know what kind of infections you pick up in hospitals? Bad ones! The sort of infections that sneer at industrial-strength antibacterial soaps and trip gaily over pools of Lysol.

I might just have to rethink all of that D&C ambivalence I was so recently touting. You know, now that this last one is TRYING TO KILL ME.

I am going to go bathe in hydrogen peroxide and Neosporin. If I don't make it I want you to know that I died with bitterness in my heart and charity towards none.

PS I am actually a little alarmed by this development and am keeping a watchful eye upon the limb in question. Don't worry that I won't order a Medevac from the Mayo at the first sign of trouble, real or imagined. I was always the kid in the nurse's office saying, "My arm hurts when I twist it above my head like this. I think we should do an MRI." Come to think of it, my arm DOES hurt when I twist it above my head like this...


Curious Julia Goes To The Hospital

"But it was her business to be satisfied- and certainly her temper to be happy; and all was soon right again." Jane Austen

I re-read Pride and Prejudice in its entirety yesterday (it is incredible how much reading you can get done when you wake up in the middle of the night and then spend the rest of the day in a quasi-sedated bed stupor) and this quote made me smile. It works for me.

The only way I can justify continuing to try to have another child is if we enjoy ourselves while we are doing so. Otherwise that is sort insane, right? I mean, it would be unhealthy to allow our disappointments and frustrations with never-ending genetic issues to sabotage what is, in every other respect, a great life.

Are you with me? Are you hip to my happy?

The D&C was fine. They accidentally over-sedated me so I was in the hospital a little longer than anticipated. People kept coming over and slapping me on the face while I burrowed further and further under that dreamy hot-air blanket thing.

"Wake up!" they'd say. Slap slap slap.

"Uhnnnnn," I'd reply.

According to Steve, we spent a couple of hours doing this.

Then there was my blood pressure. The big number at one point was 60. 60 over something littler. 30 maybe. I am not sure what that means but I do know that I had to have an escort in the bathroom and it involved more slapping.

Finally, it turns out that I was severely dehydrated. I don't want to be indelicate, but the nurse repeated a story involving catheters and volume measurements so tiny you usually only see them in reference to vietnamese cinnamon or red pepper flakes. Personally, I think a little dehydration is to be expected when you tell someone they cannot even swallow their own spit after midnight let alone a nice mug of tea but they were displeased with that too. They didn't slap me for it but they did make me stay in the recovery room until I absorbed three jumbo IV bags full of fluid.

So I was there a while. Getting slapped. And reading. At last Steve took me home and fed me soups and blue Gatorade and I was asleep for the night by 7:30.

Not a bad Monday, really. At least I got to skip communist playgroup.


Oh For The Love Of...

This is going to sound superstitious, but I don't think that Georgia Tech and Kansas are going to be meeting in the finals. I have this eerie premonition that my bracket masterdom is over. Curses.

I am ambivalent, generally, on the subject of D&Cs. I don't think they are a medical evil. I don't think they are a medical necessity. I think it depends upon how far along your pregnancy was and how you are feeling about the miscarriage and what might be happening in the rest of your life at that moment. Usually I find out that the heartbeat has stopped and I go home to wait to miscarry. Then three or five or seven weeks go by and nothing happens. No bleeding, no cramping- nothing. At that point my doctor du jour gets nervous and suggests a D&C and I say okey-dokey and there we are.

This time my OB and I discussed the options: misoprostol, natural, or  D&C. I listened politely to her review of the former (a day of intense bleeding and cramping at home followed by self-collection of the products of conception OR they could admit me for a day of intense bleeding and cramping at the hospital; the caveat was that the drug does not always work so I might wind up with a D&C anyway.) I tried to keep an open mind but, just between us, OH MY GOD how awful does that sound? I guess there are advantages to avoiding surgery but bleh. No thanks.

Besides, the single-most important thing to me in this post-loss scenario is trying to get genetic testing done on the embryo and the best way to accomplish this is by having a physician gather the POC (products of conception- I was trying to avoid typing that twice but I realized it is not exactly a universal acronym.) So I said if it was all the same to her I would prefer a D&C and she said no problemo, thus they set me up for a dilation and currettage tomorrow morning. At 7:30. Which means I have to be there at 6 AM so I have to get up at, what, 5:30? Is there a point in even going to bed at all if you have to get up at 5:30? Personally, I think not, so as soon as I am done writing this I am going to put on my favorite D&C sweatpants and go wait in the car.

Oh. Right. The car. Fuck.

Steve and Patrick went to pick up his parents from the airport Saturday morning (see previous gloating post.) Ten minutes after they left I got a call from Steve on the cell phone. A snow plow hit them while he was stopped at a stop sign. The plow actually went backwards 50 yards down a 55 mph road and then turned, still in reverse, and backed into them. They are both fine, but the car was destroyed in the front. Our insurance company will let us know tomorrow if it is totaled or if they think it will cost them less to repair it.

So:

1. Both of my NCAA finals teams are out of the tournament.

2. My one year old car was destroyed.

3. I have to get up in the middle of the night to have a D&C in order to do genetic testing on a pregnancy we spent almost twenty thousand dollars to achieve solely to make sure that I would not have to miscarry another genetically abnormal pregnancy.

You know what? I REALLY AND TRULY feel sorry for myself. And I hope your weekend was better than mine.      


Postponement

Here I was cursing the fact that we are being buried under 500 feet of snow IN THE MIDDLE OF MARCH and lo! my in-laws called from the airport to say that their flight has been delayed. Until tomorrow.

Huh.

What a shame.

Guess Steve and I will just have to watch basketball and eat artichokes and compusively check our office pool standings instead of driving in a mini-blizzard to the airport tonight. You know, this might be the only Snow Day I ever get as a hauswife.

Go Georgia Tech. Shoot. Score. D-Fence.

I made all sorts of crazy promises about what I would cover in this post but I wasn't fully processing the fact that there is SO MUCH COLLEGE BASKETBALL on right now. So I gotta go. Do I love the NCAA March tournament more than you? Um, yes. I'm sorry you had to find out this way. So who do you have picked to win it all? And don't tell me you don't care. How can you not care?

Later: D&C, basement, Patrick, etc.


Well, THAT Was Fun

No heartbeat today.

If you like we can take a moment and study our nails and think about how nice it would have been to have this all work out somehow. Who doesn't like a good miracle? Wouldn't it have been lovely if this blog could have become a googlicious beacon of hope for the hopeless instead of the scary scary swamp of pregnancy horror it is?

Every time I see another pregnancy-related Internet search has brought someone here I want to scream: Noooooooooooo! Stay AWAY! Nothing to see here!

Search term: "hcg not doubling"             My experience: Miscarriage

Search term: "heartbeat slow"               My experience: Miscarriage

Search term: "IVF with PGD"                  My experience: Miscarriage

Search term: "hcg quadrupling"              My experience: Twins! But miscarriage

Search term: "heartbeat 6 weeks"          My experience: Miscarriage

Search term: "heartbeat 7 weeks"          My experience: Miscarriage

Search term: "heartbeat 11 weeks"        My experience: Miscarriage

Sorry, I am feeling a little gloomy, a little fatalistic. I am even, dare I say it, feeling a little sorry for myself.

Anyway, I just got back and wanted to let you know what the deal is. Now I am going to finish cleaning the bathrooms (my in-laws are coming! tomorrow! for a long weekend!) and then Steve and Patrick and I are going out to dinner. I will drink wine. I will eat dangerous cheeses. And when the sommelier approaches and asks, "Will madam care for an ass-shot of progesterone in oil this evening?" Madam will respond with an empathic no.

I'll be back tomorrow and tell you what my plan is for future reproduction. Also, what colors we are painting the basement. Perhaps I will share what occurred the other day that prompted Patrick to say, with perfect enunciation, "What the hell is going on in here?" Lots of good stuff.

Thanks so much for caring. Thanks for checking on me.


Details

Bear with me while I take us back in time, all the way back to the beginning of last week. I am a big fan of the Ineffable Now and letting the dead past bury its dead and all that, but if I don't tell you what transpired between then and now I am afraid that you will have no idea what the hell I am talking about. Some of this you have heard before, so excuse the repetition but... narrative flow, baby. It is all about the narrative flow.

Last Monday the Crappiest Ultrasound Machine in the Universe (TM) showed that the embryonic heart rate had dropped from 107 bpm the previous week to 93 or something equally disturbing. Immediately following this ultrasound I met with a new obstetrician, my old obstetrician having fled the little office of horrors with the coming of the new year. The new OB saw nothing wrong with a declining heart rate and started scheduling me for CVS testing, per my initial request. In his world I would not have been seen by a physician, phlebotomist or phax machine until I showed up at the perinatalogist on April 12th.

So, either he truly believed that embryonic heart rates do not need to steadily increase during the first trimester (in which case he is utterly incompetent and I pity his poor parents who must have been so proud when he got into med school) OR he was patronizing me (meaning he knew that I would most likely lose the pregnancy but did not feel he needed to share this tidbit with me.) Now, in the general scheme of things I can imagine scenarios in which women (some women) might prefer to just go about their hapless selection of nursery accessories until they miscarry one horrifying day, but I AM NOT ONE OF THOSE WOMEN. Among other things, if I do not do genetic testing on this pregnancy I will never know what caused embryonic demise, thus I could be dooming myself to any number of terrible reproductive decisions going forward.

So I jettisoned Dr. Loser and made appointments for another ultrasound and a consultation with a new new obstetrician. That was last Monday.

Tuesday I went for the ultrasound and saw that the embryo measured 6 weeks 2 days (rather than 6 weeks 6 days or, if you wanna get REALLY specific 7 weeks and 2 days per transfer dates) and the heart rate was 74 bpm. You are no doubt too busy to google this for yourselves, so I'll just go ahead and tell you that the miscarriage rate for this situation is in the neighborhood of 100% (+/- two standard deviations to allow for the possibility of, like, divine intervention.)   

Therefore, Wednesday morning found me leaving the new new OB's nurse a message so rambling and incoherent it could have been scripted by the Unabomber. Thankfully a nurse called me back within a few minutes and, even more thankfully, she was willing to overlook the fact that I was not technically a patient of theirs. She listened. She comprehended. And then she put together a reasonable course of action.

To wit: an immediate hcg check followed by a repeat on Friday (last Friday.) Once Friday's result was available I would meet with the doctor Friday afternoon and most likely have an ultrasound with them.

I cried because she was so nice and so efficient and so responsive. Then she cried because I was crying. I doubt this sort of thing happens with a proctology practice but I do not want to be guilty of gender stereotyping so I will leave the possibility open. Still, I doubt it.

Wednesday's hcg level was 13000 and something. What does that mean, you ask? Nothing.

Friday's hcg level was 16000 and something. What does that mean, you ask? Well, nothing much. It confirms that the pregnancy is not developing properly but it also indicated that it most likely will not be going anywhere on its own anytime soon.

I met with the new new OB Friday afternoon and fell madly in love with her. She is so SMART. And she has a sense of humor. And she was a genetics counselor before she went to med school and, you know, we have genetic issues so that is a nice synergy right there.

We talked and talked and I explained my whole obstetrical history and we put together a long term plan and a short term plan and heavenly choirs sang.

Unfortunately, their ultrasound machine was in use and we waited and waited and the person did not leave. So my new best friend suggested I just come back in on Monday. And that sounded fine to me because, as I told her, I was certain that there was no longer a heartbeat to be found and I was equally certain there would still not be a heartbeat on Monday. So, it didn't affect my weekend one way or the other and it was too late at that point to schedule anything further so I would have had to come back anyway.

Which brings me to my appointment yesterday. By the way, if you were paying attention you will notice that I went to either an obstetrician or a radiologist FIVE times last week. This is why my insurance company hates me and their entire actuarial staff camps at the mailbox each month, waiting for me to miss our premium by a day so they can cancel me. Ha! Fat chance! Not with my soon-to-be-patented Toast Rack Chronological Bill Payment System.

The first thing I heard upon arrival is that my doctor was not there, as she was out delivering some other patient's baby. Mazel tov.

The ultrasound tech brought me back to the machine and tried to enter the relevant information into her SUPERSUPER Deluxe Sono7000.

Date of last menstrual period? I did IVF, so, well, I guess you could say BLAH, but the last ultrasound said BLAH but the one before that gave a due date of BLAH so...

Is this your first pregnancy? Ha! Sorry! No. Ha HA HA! It's my millionth. Not really, but, it feels that way sometimes. No, this is number 8. Wait, sorry. 9. Ninth.

I decided to cut to the chase and told her that we were not going to see a heartbeat so chop chop let's just move it along, shall we?

So she started the abdominal scan and immediately said, "Oh but there is the heartbeat right there."

And I looked at her screen and then I looked at the WALL-MOUNTED PATIENT VIEWING SCREEN (how classy is this place?) and sure enough blip blip blip. I sighed really loudly and said that it was probably just me. And she said no, she was seeing it not hearing it. And I said, yeah, something like this happened three pregnancies ago and it looked like the embryo had a heartbeat but actually it was a vessel of mine that we were seeing. And the embryo was just a disintegrating string of tissue.

Whereupon she measured the heartbeat and it was, more or less, exactly what it was last week. In the upper 70s. Then she measured the embryo and it had grown a week to seven weeks exactly.

At which point I screamed Medic! and one of the partner OBs came in. She agreed we were all looking at a heartbeat. She agreed it was really fucking slow. She asked if I was taking baby aspirin and I said, uh, well, I WAS taking all this stuff but then, um, the last ultrasound practically showed X's for eyes so I, er, stopped taking everything.

Which is when she punched me in the leg, pretty hard, and said, "Oh just take the damn pills! And come back on Thursday."

So I did. And I will.

On an editorial note, I would like to add: am I supposed to be learning patience? Is that the Great Lesson in this? I assume I must be missing something, otherwise I would not have to keep repeating the same miserable experience over and over again. I have never heard of a heart rate just staying ludicrously low and steady while the embryo grows. It was REASONABLE to expect the embryo to have died since the last ultrasound. Why is the cosmos fucking with me? Any suggestions?