Personal: April 2007 Archives

I'll preface today's entry by letting everyone know that there is some content that might make you uncomfortable, depending on who you are and what your sensibilities are. There's nothing vulgar, x-rated or crude, but I'm going to talk a bit about birth control, some medical procedures that I dealt with and my general state of mind during all this stuff, and I didn't want to surprise anyone.

I'm not going to spend any time hear talking about how I met John -- I've talked about it before, and while it's a story that I always love to tell, it's not really relevant to this one. We met in 1996 and got married in 1998, just before I turned 30.

At that time, both of us were very career focused. John was working on cutting edge technology projects in networking industry and I was finishing up my post-doc. There wasn't really time to think about having a child. And I just wanted time to enjoy being a pair. My parents had waited 5 years after getting married to have me and I always loved that they seemed to have a relationship that went beyond just being parents which made them wonderful parents and people. I wanted the same kind of thing for John and I.

After that, I went back to school to add the computational component to my training and John launched into a new job working hours that went beyond even what I put in as a grad student. Still not time. I wasn't ready and it seemed to me like he needed the chance to really put all his energy into his career without feeling guilty about having a family at home that he wasn't paying enough attention to. And this was the tail end of the dot com era and John was at a tech company -- we had hopes that his labors would pay off in the form of incredible stock option payouts.

Meanwhile, in early 2001, I got a "real job" and we bought our house. Within about 6 months my job became unstable and for the next couple of years we dealt with concerns about unstable startup companies -- on both sides. It still seemed like a bad time, I still had time.

By now what you are beginning to see is that I was really good at finding reasons to avoid the whole "starting a family thing". John always jokes with me that every guy suffers for all the sins of every other guy that his wife/girlfriend/significant other has ever dated, and to some extent that was the case with me. I had a hard time wrapping my brain around why anyone would want to give up their freedom to have a family. And I also felt, in some weird, twisted place, that having a family was giving into the ex all over again. Somehow I would stop being myself and wouldn't be valued for me any more. I would just be somebody's mom.* And I was completely freaked out by how it might change my body. And the issue of labor? Well, that was beyond really what I could think about.

We actually talked a lot about the issue of starting a family... we were watching our friends kids get older and I had started to notice that my clock was ticking. One way or another we needed to make a decision. I needed to make a decision. And for a while I just couldn't. I was scared of all the physical and emotional potential on either side. John, in his own thoughtful and understanding way, felt either option was reasonable.

And then I had one of those cathartic moments when I looked at John and I just thought it would be the saddest thing ever if I never got to see John holding a child of his own. Here I had a guy who I loved more than anything and who I just knew would be a fabulous father and would never see me as just a walking womb. Here was a guy who really would be an equal partner in the process. He was supposed to have children. And the decision was made.

But that didn't make it easy for me to stop taking my birth control pills. It was summer 2004 and I think that was one of the harder things I've ever done... quitting that ritual of cycle regulation. We didn't start trying right away... I wanted to have a couple of "protected" cycles while my body normalized after 16 years of chemical regulation. I think this was really just the whole fear thing coming back a little bit and it was a small way for me to hold onto some control in something that I knew inherently that I couldn't control once it all started rolling.

Needless to say, I was surprised when I didn't get instantaneously pregnant the minute there was nothing to prevent the whole baby-initiating process to occur. It was kind of funny to me for a while... all the time I spent trying to stay un-pregnant and even without any barrier, it didn't seem to be happening. Granted, we weren't "trying" in a focused way. And it was an incredibly stressful year at work, which didn't make things any better. But I just couldn't focus on it that way. I needed it to sort of sneak up on me and happen almost by accident.

So you might find it funny to think that when we discovered we were pregnant at the beginning of November, 2005, I was actually pretty calm about it. Not only calm, but at peace with everything and pretty happy about it. Well, I wasn't happy with the three weeks of miserable morning sickness that I had, but everything else was pretty good. That is, until I had some cramping and bleeding at 10 weeks.

That shattered my calm for the 8 hours before I could get into my doctor's office. But everything came back into focus when the ultrasound showed that I was still pregnant and everything looked fine. False alarm. Sometimes these sorts of things just happen I was told. Oh, and by the way, did I know that I had a few fibroids? No, no, nothing to worry about, but I should be aware they were there.

Scientist that I am, I opted for some early genetic screening to make sure that things were going correctly. By 12 weeks we had a CVS screen and found out that we had a genetically healthy girl. And at my 14 week checkup, on December 22nd, everything looked good and I heard a nice strong heartbeat. We decided it was time to share with our families.

On December 25th, 2005 in the afternoon I started to have some cramping. I was uncomfortable, but I didn't think too much about it, I'd been told that sometimes that happens a bit as the uterus gets used to its new occupant. In the early evening I lost my mucus plug and a rush of fluid. My miscarriage happened shortly after that. Thank goodness my mother was around and is an incredibly strong person. I don't know what I would have done without her. I feel lucky that when everything happened, I was surrounded by my family. If anything brings into focus how important family is, this sort of thing does.

My trip to the hospital was really about stopping the bleeding. A pregnancy involves putting a lot of vascularized tissue in place, and my body was evicting all of it. With through the help of quite a few medical professionals, my family and some atavan, I got through the night, got home, went on. It's still one of the hardest things for me to think about. I felt like I had lost everything. I would just have these unexpected bouts of sobbing. John was totally there for me, but had a hard time understanding. He had just been worried about losing me. The miscarriage was followed up by a D&C a little over a week later. Which didn't really help my mindset, even if it did help me find the OB that I have now and I really like working with. When I was being prepped for the procedure, it was all I could do to keep from sobbing, even though I knew there was nothing to be upset about with the procedure. But it represented the ultimate end of my pregnancy. My daughter. And did I mention that I have a real fear of hospitals. Oh yes.

But the whole thing made me resolved to try again. I was going to have a baby. There was nothing that I had wanted that I hadn't been able to achieve. I was not going to let my body get away with rejecting the whole baby having process. My doctor recommended that we give it a month or two before we started trying again to let things "get back to normal", and it felt like an eternity. One of the few saving graces was that I could head off to one of my favorite happy places and have margaritas. In the meantime, we did a lot of testing, looking for anything obvious that could have caused my miscarriage. A lot of needles and blood later (I'm not much of a fan of needles either) we hadn't found anything out of the ordinary. Which was, of course, good. But frustrating. There was nothing to fix, nothing to change. We just had to try again.

And so we did. This time I was a bit more focused about the process. I charted my temperatures, knew the timings of things. We got pregnant for the second time right after MS&W. I figured that had to be good luck. But I was going to be wrong again. My doctor's office did blood work at 5 weeks to confirm the pregnancy. My HCG levels were a little lower than they liked, so I had another draw at 6 weeks. Worse news, my HCG levels weren't rising. A follow up ultrasound didn't give much hope. Fortunately my OB was wise enough to suggest waiting a few days before scheduling the D&E so that we could do another ultrasound just to make sure things were at an end. I miscarried naturally without any need for surgical intervention. It was a small blessing for me. And, as my doctor said, at least we had one thing going for us -- we could get pregnant. A lot of couples get stuck at that part.**

This loss was a little easier to deal with. It happened earlier and I had a good deal more warning. It was easier for me to chalk it up to a bad genetic outcome, which is usually what these early miscarriages are. And given how hard the first one had been, I'd had a harder time getting invested. I was consciously staying as reserved as I could.

Not too long after that, John had his retinal problems and I just couldn't think about our baby problems. If I'd been offered a deal of having children or ensuring John would always have his vision, it would have been an easy decision in John's favor. All that mattered was that we took care of him and his eye. By focusing on John it was easier for me not to think about the fact that my uterus seemed to be rebelling against me.

The ultrasound I had after the second miscarriage to determine if everything was clear or not tool me back to the fibroids. There was some suggestion that one of the mostly benign things was actually on the inner wall of my uterus. A sonohysterogram a bit later determined that this was, in fact, the case, and that the thing was taking up 3-4 square centimeters of perfectly good, baby -supporting uterine real-estate. My doctor talked to a reproductive endocrinologist and the verdict was that it would be a good idea to remove it.*** At the end of August, I was back in the hospital to have it removed -- it was a pretty mellow procedure as these things go. No incisions required. Most of the work was done as a D&C would be only the tool had a scope and a cutting tool that would be used to remove the growth. But I hadn't suddenly developed a love of hospitals, so this experience wasn't particularly more wonderful than the early January experience. But that's probably a story for another blog post.

Everything went fine with the surgery, and my doctor told me that I was going to have a period that went on for several weeks while things healed (fun, fun) and that I needed to wait at least two cycles before we tried again. John told me that the next time he wanted either of us to be in a hospital was when we had a baby. I couldn't have agreed with him more. And then he smiled and told me that he was sure the next time would go fine. After all, it seemed like I had to do everything three times before it worked.

Baby Z, is, in fact our third time. I consider it a sign of some kind of providence that we got pregnant on the very first try after my surgery. And it's been a very well monitored pregnancy. I've had 4 ultrasounds in 20 weeks (some as a substitute for the more invasive means of genetic screening) and a whole lot of blood work. I still spent (spend?) a lot of time convinced that something bad was going to happen, that something was going to take this one away from us, too. But so far, everything's been perfect. I was barely morning sick (more like a little dizzy for a few minutes in the morning) -- which of course had me convinced bad things were happening -- not very fatigued, and I've felt pretty good through the whole thing. Every time I've heard her heartbeat, its been a treat. Every time I feel her move, it makes me happy. It does seem like the third time is going to be the charm. Knock on wood.

I decided to tell this story because one thing I discovered after my first miscarriage is that it's just about the lonliest thing that has ever happened to me. It's not something that you can talk about easily to other people. It's a sad thing. You bring back sad memories for those who have been there, and those who haven't can't really imagine what its like.

I went back and forth a number of times about talking about it here, and finally decided that now was the time for me to share. I wanted other women out there who might read my blog and have had the same misfortune to know that they are not alone. In fact, it happens a lot more often than you might think -- some statistics suggest that as many as 30% of pregnancies end in miscarriage. So a lot of us have to deal with miscarriage. But not all of us get much support for the process.

Hence my post. If someone out there needs a sounding board, or to tell their story, I'd be happy to listen. I know how hard it is to see other pregnant women, and how it seems like every woman you see is pregnant. How it feels like you have lost everything when the biology doesn't work the way it's supposed to. I know how that fear of loss creeps into the next attempts and makes it so hard to believe that things are going to go your way (believe me... I'm still wrestling with that one), and the frustration with all the medicalization of the process. I've been there and I've wrestled with it myself. So to anyone who needs to talk. I'm here.

*this is not meant to be offensive to anyone out there who is a mom... being somebody's mom is a very special and important thing... this is just to help set the stage for where my headspace was.

** again, I'm not trying to make light of anyone's situation, nor was my doctor. I do feel very lucky that we don't have fertility issues that complicate the situation. And my heart goes out to those that do. When I think about what some people have to go through to have baby, it makes my ordeal seem pretty small.

*** if you talk to 10 different OB/gyn doctors, you will probably get about 10 different opinions on whether fibroids cause problems for pregnancy. It's controversial subject material. But it certainly gave me peace of mind to know the darn thing was gone... I know if I hadn't had the prorcedure and I'd had a third miscarriage, I would have always wondered if it could have been prevented by having the fibroid removed. But a lot of people don't think that a fibroid as "small" as the one I had can really have much impact. Hence the controversy.

As I started to think about my path to pregnancy, I realized that the story actually starts quite some time ago. Almost in high school. So you'll have to bear with me as I set up the story. Be cause the road to Baby Z really has two parts: dealing with my own hangups and dealing with some medical things that were beyond my control.

You see, I've always been a very career oriented girl. I had both my parents telling me as I grew up that I could be anything I wanted to be and that I shouldn't let other people put limits on me or tell me what I should or shouldn't like doing. Growing up in the 70's and 80's there were all sorts of exciting scientific things going on. My dad bought our first computer when I was 12 and I loved the thing, even though at school, the only people into computers were the truly geeky guys. But my first love was always biology. And when I got to my junior year in high school I discovered immunology and I was pretty sure I had found my calling. I was going to become a research scientist and save the world with my discoveries. Hey, I was 17 and I still believed I was invinceable. And I was a geek who wasn't very comfortable socially, so I needed to believe that there was something important out there for me to do.

So college was all about achieving that goal. I did undergraduate research, researched good grad schools, focused on science as much as I could. It was all about getting to the place where I could start to solve big problems in science. In the end, I was pretty proud of myself. I got to speak at undergraduate research conferences, I won a National Science Foundation Predoctoral Fellowship and was actively recruited by more than one prestigous graduate program. From a career standpoint, life was good.

During college I also met a guy that I thought was on the same wavelength as I was. Like me, he came from the midwest (he grew up in Chicago) and he was looking at a serious scientific career as an MD/PhD. We started dating sophomore year and by senior year we were picking our graduate programs together. Which is how I ended up at the University of Chicago. It was the one good university that we both got into together.

Time went on and after some intial bobbles, we ended up living together and engaged. That would have been all well and good, but it was about this time that I started to discover that he and I didn't have goals as similar as I once thought we had had. We both were driven by our careers, but it became clear that my career was really secondary to his. Whether it was comments about not wanting to get "just a PhD" or suggestions that I didn't spend enough of my time keeping a clean house, I began to suspect that in the case of the fiance, driven might be re-interpreted as controlling.

After we got engaged, he started planning out the future. He loved kids and definitely wanted to start a family. His own family relationships had been chilly, and he was always trying to prove to his parents that he was good enough for their approval. Which he never got. So he channeled all that insecurity into trying to control the rest of his environment agressively. He decided that we were going to have our first child when we were 27 and our second when we were 30. He didn't really discuss this with me in a way that was negotiable. It was just the thing that needed to be done. He didn't factor into the equation that I would be doing my postdoc in a competitive field that required as much of a time commitment as a residency and didn't cut women any slack for having babies. He didn't factor into the equation that he would probably be doing a residency and would be on call and would leave me with most of the child care responsibility. He just decided that this was what we needed to do. It didn't put me in a very good headspace. Especially when he followed it up with the fact that it was going to be very important for me to keep my weight in check during and after pregnancy. It was beginning to become clear that I wasn't much of a person to him... I was a child-bearing vessel and an arm trophy.

A smart, driven, self-confident woman would have handed his ring back and walked out the door at this point. I like to think that I am smart and driven, but at the time, between the fiance and the learning experience that is graduate school, my self-confidence was at an all time low, and I was convinced that if I couldn't make things work out with this guy, I might spend my life alone. A pretty stupid thing to think as a 24-25 year old woman, but my social skills had never been strong, and I was pretty painfully aware of that. So instead of just telling him he was a jerk and to find someone else to be his glorified arm trophy, I stayed around and started becoming very resentful about the idea of having children and got very religious about making sure that I took my birth control pills when I was supposed to.

One of the things I thank my lucky stars for every day is that we got engaged and then set a wedding date for a year and a half later. It created plenty of thinking time for both of us. Especially when I went to a conference in New Mexico in the spring of 1995. I came back with a new resolve to make things work. He came to the conclusion that things could never work. I was devastated. The real kicker? The reason he told me that he was doing it was that he didn't think I would be a good mother to our children.*

That split, while immediately painful, turned out to be the best possible thing that could have happened to me. People who saw me the next day as I told them what had happened said I seemed happier than they had seen me in ages. And in truth, I was scared of the whole being alone thing, but it felt like the great weight of a bad relationship had been lifted, and I was now free to focus on the things that were important to me again: my career, my hobbies and finding someone who would really value me -- although I didn't necessarily approach them in that order. The whole "having a family" thing went completely out the window.

And then, in the spring of 1996, I met John.

* I know all of this stuff makes the Ex sound like a real self-centered heartless bastard. In truth, he was just a regular guy with personal issues that he couldn't really get past, and he got focused on one very particular solution to those problems. At the same time, I wanted to rescue him from his demons, because I'd always had a warm, loving family environment, and I thought I could help him have that, and could change the stuff I didn't like. As a result, I enabled a lot of bad behavior on his part. After we split up, it was clear to me that we were better friends than partners, and that trying to change someone to get what you want isn't really a healthy relationship strategy. People are what they are. I don't really regret him, or coming to Chicago. But I do regret not having the strength to stand up for myself when I should have.