The Unplanable Planned Pregnancy

Okay, I'm married.  We're reasonably settled and successful.  We're happy.  Let's expand our love and happiness into little people.  Let's get pregnant!

Lot's of thinking goes into that conversation, planning, thinking about college funds, preschool, nursery furniture and cool carseats.  It's exhilarating.  We are planning life.  How awfully grown up of us!  So, like responsible, scientific people we start  the process of "trying to conceive".  We had charts, and checked mucous, waiting for uncomfortable "middleschmirtz" so that we could "create new life".  And we waited.  And charted.  And waited.  It should take up to 1 year to conceive, according to ACOG.  I'm a medical student, I know what to do and when to do it.  This should be cake, and fun cake at that.  1 year became 2, which then became 4, which became 6...then 7, now 8 years...

Now, I'm angry.  My friends all have 3 kids and they can plan to conceive the next one over spring break.  And they will.

Somewhere along that year, I realized that I was desperate to help others achieve something that I wanted; which only started as a spark of curiosity, and now was an all consuming fire.  It was burning up my relationship with my husband, my friends and what I believed myself to be.  The whole point of being a "woman" was that you could create life, grow it in you and push it out, feed it and raise it.  I'm failing as a wife, and as a woman.

Being adopted, we very cautiously danced around the subject of adopting a baby.  But for me, It wasn't about having A baby.  It was about having MY baby.  Unlike my husband, his brother, and his father and uncle that all look like identical twins... I look like no one.  I wanted a baby that was mine.  I wanted to be related to someone.   Now, the discussion became a plan, and, the plan became an obsession.

Sex became a science-fair-project of dates, blood draws and drugs that turned me into some estrogen crazed, migrainy monster.  And every month, like clock work... day 28... failure.   Clomid, Femara, progesterone suppositories, sperm counts, special vitamins, hopeful ultrasounds of my "follicles", and trigger shots, with frantic plane rides to get to him in the next 36 hrs to "make a baby".  Taking progesterone to keep "it going" when I knew in my soul that my uterus was vacant - again.  Not wanting to stop the progesterone, to prove my brain right...  anything, to pretend that maybe, just this month, it would work.

Nothing.  Except bills.  Slammed doors, sopping wet pillows from crying myself to sleep.  Chris in another state during most infertility cycles for work, which was God's grace in protecting him from the anger that I just found harder and harder to stuff.

I knew in-vitro-fertilization was an option.  But, I didn't want to go there; it was the end of the road.  If I went through that and failed, then I felt like a failure not only as a doctor, but as a woman, as a wife, as a way to provide continuation of "the family name", and mostly to myself.  As a woman, I can make my own little relatives; important when you have none.  Except that I couldn't.  Now, I found myself sitting across from an REI (Reproductive Endocrinology and Infertility) getting ready to decide if I could go down the last road available to us.  At the end of this road was going to be more money gone, all hope gone, and a vacuous uterus in the next 28 days.

Most infertility patients know what cycle day they are before they know what day of the week it is.  After the usual greetings, most of my patients happily blurt out what cycle day they are like the rest of us discuss the weather.  I was able to get so many people pregnant.   Everyone but me.

We discussed, prayed, and saved all the money we could.  I knew that this was the last paper thin layer between my dream, and unspeakable grief.  There would be no more "cycles" after this.  The monthly emotional devastation was taking it's toll.   I'm an OB/Gyn for God's sake.  I had to "get it together" to care for my patient's needs.  There would be no adoption, no plan B.  We said, "OK".  We signed on the 10,000th dotted line and went home.

Next day, I got a package in dry ice of vials, saline to mix it in, more injections, lots of needles, and my very own sharps container.  I slumped to the floor cradling this tiny box, hopeful that it would produce life, then sobbed so hard I almost threw up.

We were given a calendar.  I was obsessed with it.  Checked it every day to ensure there was nothing I was missing.  I had ultrasounds every day to watch the "crop" grow, getting more hopeful by the day.  Retrieval day, I go off to a surgical suite for follicular retrieval while my husband is ushered into the "little room".  This is after he's watched on a big TV the doctor going at my ovaries with a 18 inch long needle... it's time!  He's gotta perform.  And, it's gotta be the best sperm of his life.  No pressure...

And now, we wait.  Check to see how many survived the night.  How many fertilized the next day? And now how many are alive?  And, we wait.  And wait.

Easter morning was scheduled to be my embryo transfer (the embryos sucked out 5 days ago, placed in tiny tubes of "growth media" had grown big enough) and as I waited prepped, with my legs apart and shaking I hear, "well we've got 2 pretty good ones" to put in today.  What I found out later was that of the 18 embryos, all of them had died the night before except 2.  Fortunately they were very positive, and I was such a bundle of nerves, that it hadn't dawned on me to ask what happened to the other ones.  I went home - pregnant.  Finally.  At least for the next 10 days...

Let the 10 day roller coaster of your life commense.  "Im not pregnant (*sobs*)! You know, hon, I really feel different this time.   No, there's no way I'm pregnant.   Oh, I just KNOW it worked.  Do I look pregnant? (it's not even the size of a grain of rice at this point)   When should I tell work that I'm gonna need... I JUST KNOW IT DIDN'T WORK.  Why is God doing this to me?  I think I just felt sick?"

It hit a Zenith in the middle of a C/S with one of my OB attendings, while closing the fascia and listening to a newborn crying across the room, the tears fell down my face, collecting under my mask making a tiny pool under my chin.  I tried to keep very quiet, but as we walked out (he's not usually the feely type of guy) he looked at me and said, what (cycle) day are you?  Before I could collect myself to squeak out a number he said: "Look at you.  You are so pregnant."  With that he burst through the double doors to the stair case leading to the operating room.  I was supposed to follow him, but couldn't.  He was usually not wrong.  What if he was right?  What if he was wrong?

I drove across the street to pick up a pregnancy test and couldn't wait long enough to get home and use it.  So, Panera bread's bathroom looked as good as any.  I had a procedure in place, as I had done hundreds of these useless tests over the years. Pee, then place it on the back of the toilet, so not to see it until all done, with hands washed.   I turned around and saw 2 lines.  I fell backwards into the wall and held it right up to my face. Angleing it into the light just to make sure I wasn't hallucinating a fake line.  As it got stronger and stronger, my face got paler and paler...

I burst out of the bathroom, ran to the bagel counter and shouted to the whole restaurant that  I WAS PREGNANT.  I ran out into the rain to call Chris, and yell it to any stranger on 15th street that cared to hear it.  Finally, we made a person.  A miracle placed in me on Easter, that decided to share his glorious birthday with none other than Jesus Christ.

I was fortunate enough to do another cycle that worked as well as the first, and have frozen embryos that we implanted some 3 years later.  So, Jonsey and Jordan were conceived at the exact same time, yet born 3 years apart.  You see, some people plan pregnancy, and get pregnant.  Some people plan not to get pregnant, and get pregnant.  Then, there's the rest of us.

Pain 101

I was laying in bed, not able to sleep, with my knee throbbing (don't drive a motorcycle into a brick wall) when I started contemplating the purpose of pain.  I know there are books on it, there is entire medical specialty devoted to it, numerous therapies so that some can cope, but why?

I then let my mind wander into the different types of pain, and reasonable explanations for it.  I think, as humans, the rationalization of what we experience must be what keeps us sane.  And, to that end, there may be some explanation for why the inability to process pain in a helpful way can drive some to insanity.

Pain in my experience has two purposes, teacher and healer.  Some experiences allow for both, some only one.  Those that experience pain with no resolution are those that can never be completely alive. Let's start at the very beginning, (the one I'm most familiar with) childbirth.

I see anxious mothers every day, asking "How will I know if I'm in labor?"  I always say the same thing, "Babies don't come out without a lot of bleeding, or pain.  If you have neither, you're probably not in labor."  To that end, labor pain is probably one of the most demanding physical pains imaginable, but, manageable.  Why?  It is because is predictable and because it has a visual (or time able) endpoint.  It is when you can wrap your head around this, that you can do it.  Of course, there are modifying factors like pitocin, or a baby in an unusual position, but if we didn't have epidurals in our backs we could do it.  We just don't want to.  We are programmed to fear pain, and therefore, if we have a reasonable escape, we take it.  It doesn't make you any less human, or motherly, for that matter, (I had epidurals with all of my children) but I think that any mother that has labored can tell you that it is one of the most painful experiences of their lives.  But here's the golden nugget, epidural or not, we learned something that day.  We all learned that we can take on more pain than we could have imagined, we learned that we can, in love, create life and push it into existence.  The Father learns something too, (I'm paraphrasing from a nursery nurse on this one) that his wife is strong enough to kick his ass.

As a child, pain also serves as teacher.  You usually only shut your finger in the door once.  You fall riding your bike, but you learn balance.  You fall in the frozen over lake only once; step in a hornet's nest only once.  Additionally, you learn, that when hurt, you go for help.  When you receive the assistance that you need, then you begin to heal.  We all know that there is nothing magic in a band-aid, except for the loving person that placed it on your knee.  As time moves forward, the hurts become less visible, yet more profound. 

Some of the hardest pain to comprehend is disease or sudden death.  Often times, this pain is an infinitely deep hole within us or, it is the suffering that we do out of empathy and anger for the pain of another.  This is when we, as humans, try to comprehend the complexity of the life cycle.  I have thought about this for many years, and have no acceptable answer.  I've held 10 week old babies in my hand, with the Mother's head against my chest, both of us sobbing.  I've been to glorious celebrations of life that lasted more than 90 years, and yet, the pain is there, palpable in my throat. Even now, as I write, my chest is heavy for a 16 and 26 year old fighting cancer with their very life. The weight on my chest is for both of these girls, in the prime of their life, hoping that their physical pain is purposeful in some way, and praying that their families learn something valuable from their struggles.  And they will.

You see, there is no one on this earth that can understand the loss of baby like a mother that's lost one of her own.  Some of the most caring, compassionate people (many whom have formed organizations to help others world wide) are those who have lost someone to a chronic illness or a sudden death. Rationalization of pain in this way, and putting it to constructive use, both teaches and heals.

Sometimes, though, pain just has to be absorbed quietly, in solitude.  Sometimes it pours down your cheeks uncontrollably.  Sometimes, there's no lap, no band aid, no hand to hold but your own.  These are the times when pain teaches the greatest life lessons.  These are the times when you learn that you can go it alone, that you did all that you could, that you have to let go, that you are good enough, and that eventually, it's going to be okay.  It really is darkest just before dawn, (I promise, I've been looking out the window for a while writing this) and the sun will shine again.

Happily Ever After

We went to a couple of weddings with the kids last weekend.  I realized that it's been quite a while since I've gone to one.  It seemed like, for a while, we were always going to someone's wedding. Then, nearly abruptly, there were none.  After some thought I realized that weddings, like most everything else, have a life cycle.

When you are a kid, you go to very few weddings, and are they ever magical!  The bride, usually some friend of the family, or a baby sitter who usually runs around in cut-offs with hair in a messy pony tail, walks down the aisle, transformed into unspeakable beauty, arm in arm with her dad.  I remember the collective gasp that filled the sancturary as I witnessed my first wedding.  I really thought a fairy had shown up and miraculously turned my neighbor into a veritable princess.  I was hooked.  I wanted to be a bride more than anything on earth!

Over the years I bought some bridal magazines, just to read and dream.  My friends and I would talk about our wedding, someday, when we're grown-ups.  We would drift off to sleep mumbling about music, shoes, veils, and the perfect dress.  We never did, however, outwardly dream of the "perfect groom", just the perfect wedding.  As far as finding the right guy, everyone told us, we'd "just know".

After high school, through the end of college, every one you know is getting married.  There are endless cross country trips, big dresses, parties and the joy of watching your closest girlfriends one, by one, by one, turn into a princess for the day, then ultimately, into Mrs. New-Last-Name.  At times a little embarrassing, since we are all so young, yet "grown up", but not grown up enough to have the financial resources to physically help the couple that is so dear to our heart.  It was always so curious, yet heartwarming to me as a 20-something, as to why there were always so many "old" friends of the family that would take the large portion of the day or night to attend a wedding of a young person that they hadn't seen in many years.

One day, it was finally my turn.  I had found the love of my life, the wedding and honeymoon planning was complete.  We had a wonderful celebration filled with many of my college, high school, and life long friends.  Many of these folks were people that had known my Mom, Dad, and Grandparents, much better than they knew me.  I was so encouraged to see faithful, strong, solid marriages there for me that day to send us on our way.  It was a beautiful day.  I saw the children of my married friends, and children that I used to baby sit gasp at the back door of the Church that hot July day.  I remembered their look, and now they were looking at me.

Opening presents that evening was overwhelming.  I remember opening a box from a sweet old Lady friend of my now Mother-in-Law.  Inside was my entire silverware set!  I opened a box from a old boss of my mother to find an entire set of cookware.  The list can go on, but I realized that from those older guests of mine on that day, I received two gifts.  First the gift of example of faithfulness to their marriage covenant and what that really looks like year after year.  Secondly, I received the practical tools to run a household, things that 22 year olds physically and financially can't get for each other.  The picture frames I received from my high school friends are priceless to me, but in my cedar chest.  I will use my cookware in about 20 minutes and feed my children with the same silverware I received from Mrs. Wingate 19 years ago.

It's been about 10 years since the last wedding I attended, until last weekend.  I now know what it takes to keep a marriage strong, run a household, and helped two young couples on their way last Saturday.  I remember thinking what a blessing those "older couples" bring to the table.  I was thinking of how important it is for my daughter to experience this, and that little girls need to see not just the day to day living out of the marriage covenant, but the beginning of "happily ever after".

And so, there we were, in our Sunday best to watch our neighbor's best friend on her special day. As the prelude music finished, the church became silent.  With everyone on their feet, perfectly still, the back door of the Church opened, the organ started, and my eyes filled with tears hearing my own daughter gasp with delight watching the bride glide down the aisle arm in arm with her dad.