strange place

it is so hard to believe that 8 years is coming up in less than 2 weeks. it simply does not seem possible that Jesper has been gone that long, even though all of the evidence points clearly to the truth of it.

we failed again this year to get the missing angels bill passed. not only failed, but didn't even make it out of the first committee. regardless of what anyone thinks or says, i feel like it is my fault. i got very nervous and didn't present our case very clearly at all. not sure i answered questions right. i feel guilty. it is the only time i've ever had to do it alone. without Carin. and i feel like i let her down in a huge way. as i watched in absolute horror, the bill was blithely tabled as if it effected no one. i was distraught enough to make the governor's security detail nervous when i went up to see Keith after the committee meeting. i'm still pissed. i'm growing to very much dislike some of the legislators who are elected to office in this state. so much changed this year, too. new governor. new sponsor. and very soon a new representative. i won't quit, but i can't say i'm going to come out of the other side of this process with the same faith in people i had before.

this #8 feels odd for other reasons, too. Willow is starting to talk about Jesper a lot. we talk about how he is and always will be a baby. and of course babies need to have nur-nur (that's what she calls nursing). sometimes she will tell me that Jesper nur-nur's on her "ipple." i gently correct her and say that he was her brother. that someday she will nur-nur her own babies on her ipple, but that he is my baby.

three seems to be the popular number around here these days. feels like everyone either has 3, is having #3, or wants 3. sometimes i want 3, too. or is it that i just want #1 back, so that my set of 3 is complete? either way, it is a tiny stab of hurt when someone else has 3, and i have to learn to live with my incomplete set.

in january, my friend and midwife, Jinny died from cancer. she was a wonderful, amazing, strong, vibrant, funny, profound woman. i'm so glad that two of my babies were cared for by her. i feel blessed and privileged. i will miss her; i'm not alone in that, though. i miss her a lot right now in a way that probably not too many share with me.

since it is april, Jesper is on my mind and my heart a great deal right now. i'm reliving the last days and weeks of my pregnancy and his life. this is nothing new. i do it every year. tied in with my thoughts of him, however, are thoughts of the others involved in this little drama. Jinny, Sonja, Jeff, my parents, and so on. there aren't too many people in the world who knew Jesper. Jinny and Sonja are really the only ones other than Jeff and i who interacted with him on a regular basis. and now one of the few is gone, too. that hurts. in missing him, i miss her. in missing her, i miss him. he seems somehow diminished on this earth because there is one less person who remembers him with me.

one thing is constant, though. every year rolls by without fail. and every year brings me to a new place.

breathless

sitting there on the plane. late at night. jeff sleeping by the window. nate sleeping on the seat in between us. willow sleeping in my arms.

there he is again. my beautiful, quiet, missing boy. his face with little blond pigtails. sleeping so peacefully.

every time i see it, it leaves me breathless.

boo boos

we have unfortunately been going through our fair share (and then some) of bumps, bruises, and stitches lately. nate had his first trip to the doctor for one such event, we decided to forego the doctor for the second event, only to be followed recently by another that did require medical intervention.

nate's arm

courtesy of rough housing with mama

this was actually before the splint that was eventually put on it. before even the trip to the hospital for the x-ray (this was taken at urgent care). he had the splint on for a few days, then it didn't hurt anymore.

willow's forehead

courtesy of papa leaving her on the couch and nate letting her fall off

same day, nate's eyebrow

courtesy of the same couch and nate's own silliness

nate has recently had a "thing" for falling into pillows. he decided to try it on the couch pillows. our couch has wooden arms. apparently, he missed the pillow and instead hit the edge of the arm of the couch. came to us crying and bleeding. after cleaning it up and assessing the damage we decided butterfly stitches would be sufficient. so we cut some down to pre-schooler size and fixed him up. it didn't bleed very much or for very long. but he's got a nice scar!

where were jeff and i, you ask, when he decided to do his flopping? why, we were both in the bathroom getting ready for the day. nate and willow and i were going down to albuquerque that morning with some friends! what a way to start the day for both kids (see willow's forehead above). i was nauseated the whole rest of the day just thinking about nate's eyebrow.

just recently, nate's chin

courtesy of the classroom floor

[picture to come soon. it is still on my camera.]

last week i got a call while nate was in school. apparently he tripped and fell in the classroom and split his chin open on the floor. nothing else, just the floor. it wasn't bleeding bad. his teacher had cleaned him up and put a bandaid on it. she had called only because he asked her to call. she said he was calm about it, but when she put him on the phone with me he broke down in tears. i asked and he said, yes, he wanted me to come get him. so i woke willow up and went.

inspected the chin. it looked like there was a big chunk of skin missing which told me that it was a deep cut. this time i didn't think butterfly stitches would do the trick. not on his chin. so off we went to urgent care (after a story and snack, of course, because he didn't want to leave school).

the MD offered stitches or glue. with stitches he probably wouldn't have much of a scar and he could go to soccer practice that afternoon. with the glue, it would be a bigger scar and he'd have to be much more careful with it. stitches it was! three of them to be exact. nate really didn't like the numbing injection. (the doctor tried to tell him it wouldn't hurt as much as a vaccination. except we don't do those, so his argument was moot.) the cut was cleaned and stitched. and we went home to nap--without a tetanus shot or antibiotics, thank you very much.

nate says he never wants to even drive by urgent care again. we took his stitches out here at home a week later.

nate's finger

courtesy of nate's own clumsiness

[picture coming soon. i haven't even taken it yet since it just happened today. i expect it will be really pretty tomorrow.]

nate tripped and tried to catch himself with the back of his wooden chair. instead of stopping the fall, he fell with the chair and pinched his finger between the chair and the floor. it throbbed as all good smashed fingers do for some time. it swelled up pretty good, too. i checked for a break but didn't find one. so we let it be. after nap time he wasn't crying about it anymore, but it was already starting to turn purple. we'll see how this one progresses. there is a chance he'll lose the nail at some point down the road.

the really funny thing is when nate was little he'd take a fall and get right up. maybe a few tears, but not much. he was usually good with a little hug or even a kiss on the boo boo and off running again. he even got to the point where he'd kiss his own boo boo and keep going. he took spills that made jeff and i hurt, and he wouldn't even hardly bat an eye. now he cries and cries and cries and whines about the littlest thing. not that any of these injuries are small. not that they didn't hurt like hell. but i know he's taken worse spills and not hardly shed a tear. (i'm thinking of the time he fell and hit his forehead on the door jam. OUCH!)

things i never thought i would think #2

this is just one of the many reasons why i am still working on recovering from willow's birth.

i have delivered three children (which you probably know by now). none of my labors have been natural. none of them have been particularly short or quick. delivery with nate was pretty quick and easy, but from induction to delivery was still many hours.

of all of my labors, willow's was by far the most difficult. jesper's l&d was 36 hours, with 1.5 hours of pushing. willow's was 48 hours with 2.5 hours of pushing.

with jesper, i was completely terrified of having a c-section. i only had one dream when i was pg with him about being pg. it wasn't about having puppies or having a boy vs girl. it was at about 34 weeks. i dreamed that my baby died before being born. that when i went to the hospital to deliver, for some reason i couldn't deliver vaginally and had to have a c-section. that when i woke up in recovery i was told "something went wrong, and we had to take out everything." so you can imagine my fear at the suggestion of a c-section, especially after the first part of the dream had already come true. oh, yes, it was suggested (felt more like a threat at the time). "we'll try labor, but we expect this to be a c-section in the end." i still can't bring myself to recommend that doctor to anyone.

with nate, the spectre of a c-section was no where to be seen. thankfully.

with willow, i didn't think a c-section would be anywhere on the horizon either. but i will admit that after so many hours of hard labor and even more hours of pushing, it showed up again. but instead of it being the suggestion of my doctor, it came from my own head--of all places. i had been pushing for probably 2 hours already, still about 30 minutes from being done, and i thought, "i can't do this. something is wrong. i can't do this. get her out. i want a c-section. i can't do this anymore."

that's right, i thought it. in that moment i wanted a c-section. i had already had that moment of absolute terror when they couldn't find her heartbeat with the external montior. so i already had that fear of losing her hanging around. and i knew my labor was long, that pushing was taking too long and i was not making enough progress.

ultimately, i didn't have a c-section. i was able, finally, to push her out. and i'm happy about that. i am thankful and grateful for the support of my family and health care team (even though, in the moment, i was less than eager to listen). i think with a different team, in a different situation, without everyone pulling for me and having that confidence in me, i might have easily end up with a c-section. because i certainly didn't have the confidence in myself or my abilities at the moment.

medical ethics: part II

standard of care:

this phrase has been used by quite a few health care workers and others in reference to why my back-up doctor effectively fired me at 39 weeks pregnant for refusing to agree to take prophylactic antibiotics during labor and delivery. and cited as the reason why basically all the other doctors in santa fe would refuse to take me for the same decision.

i can understand "standard of care" . . . right up to the point where i am no longer allowed to take an active role in my own healthy care . . . right up to the point where i am no longer allowed to make my own **informed** decisions for myself or my children . . . right up to the point where it becomes a mandate for debatable or questionable treatment . . . right up to the point where it is used as a catch-all scapegoat phrase that saves doctors from having to actually talk to their patients in an intelligent way.

during pregnancy there are quite a few things which are considered "standard of care." for instance, 20 week ultrasounds, gestational diabetes testing, group b strep testing, AFP tests, amnio for women over 35, monthly then bi-weekly then weekly prenatal appointments, and the list goes on.

but here's the thing, it's ok to refuse ultrasounds. md's don't like it, but they can live with it if you choose not to have one. the same thing goes for amnios in women over 35 and AFP testing. some women have even been known to refuse gestational diabetes and GBS testing. though admittedly that is probably more commonly done by women who are under the care of midwives. and more easily accepted by midwives. and no one (midwives, md's and patients alike) blinks when one or the other party misses or skips or pushes back a prenatal appointment. no big deal.

so why is it such a crime to choose not to take prophylactic antibiotics during labor and delivery? why? if the "standard of care" functions as a *guideline* in all those other cases . . . if they are options, not mandates . . . then why is this issue different? why am i suddenly wrong for making an informed decision that doesn't mesh with theirs? why is that decision actionable where the others aren't? if doctors are going to fire patients for refusing their "standard of care" shouldn't that apply equally to all? aren't they all, according to the western medical model and the standard of care, equally valid and important tests and procedures?

"because we live in a free country," you say? yeah. exactly my point. don't i live there, too?

high on crack??

we are done. so done. beyond done. done. done. done. having babies, that is. done. no doubts about the doneness of our doneness. (hey if W can make up words, so can i!)

and yet . . .

i feel a certain sense of sadness at being done.

at never getting to feel another baby growing and rolling around in my belly. men don't get this. they can understand it in concept, but not in reality. there is something so absolutely precious and special and, frankly, indescribable about having a life growing inside your own body. the absolute wonder of it.

at never having the chance to give birth again. i have always felt a sense of power and accomplishment in giving birth. i felt it the most with jesper, but certainly some with nate and willow as well. *i* did that. because there was always some part of me that wondered if it was even possible.

at never having the chance to gaze into the face of my newborn again. new babies are amazing creatures. and looking into their faces and making that connection for the first time is truly awesome. to see and meet this person that you created and that you have shared such intimate space with for so many months. and to see the recognition in their eyes of who you are.

at never getting the chance to see my blob of a newborn change into a little person. and, yes, i know that willow is still in the middle of that whole process. and still has far to go.

at never getting a positive home pregnancy test again. the anticipation of a BFP is a double-edged sword. when you are trying and trying and wanting it so badly and getting BFNs for months on end, it is one of the worst feelings on earth. but that one test stick that says YES is instantly exciting and scary and pure happiness. i think if i were to test today, even knowing full well that it would be negative, i would still feel a certain sense of sadness at the negative. psychotic, i know.

at never getting to breast feed another child. i know! i'm barely past the hardest part of nursing with willow. i know! i have, hopefully, another two years or more (please!) of nursing willow. i love nursing my children. i would happily still be nursing nate. i would happily have tandem nursed my children. i love the physical and emotional connection that comes with nursing. it is the next best thing to being pregnant.

i think part of all of this is learning to cope with willow's birth. but also jesper's death and birth. and nate's birth.

i feel a certain sense of failure. not because willow isn't absolutely perfect, but because her labor and delivery weren't. in fact, to me, her delivery was as close to a disaster as i could get without actually having a c-section or losing my child. so i'm sad that i'll never have another chance to "get it right."

but it is also just sadness at the reality of saying goodbye to that part of my life. not that i'm not excited to be done with babies and TTC and being pregnant and diapers and sleeplessness. not that i'm not excited to get on with our lives. not that i'm not excited to be able to start getting rid of all the baby crap and get my house back! but there is still that sense of sadness. will it ever truly go away, or will it always be there, just a little bit?

and every pregnant woman i see or pregnancy that gets announced is, to a certain extent, another reminder of what i will never get to do again. not that i am not happy for anyone. and not that i **really** want to do it again. but there will always be a part of me that is a little teeny bit jealous.

the thing is, i know i'm not alone. i know that women feel these same things every day for different reasons and at different times in their lives.

and i know that my husband thinks i must be smoking some really good crack right about now. but i also know that there is no way he can truly understand, try as he might.


Jesper: April 2003 (41 weeks)



Nate: August 2004 (40 weeks)



Willow: May 2008 (40 weeks)

things i never thought i would think #1

you would imagine that having already lost one child the concept of losing another one would be sort of ever present. that it might even be a driving force during subsequent pregnancies.

i would say, with nate, that i was generally concerned it might happen again. but i didn't really think it would. i got scared when, seconds after he was born, he was across the room on the warming table not crying. but even then something in me knew he was ok. maybe it was the noise in the room. it didn't *sound* as if something was wrong. (yes, things sound different when something is wrong. they just do.)

with willow, it started out as less than even a concern. i was annoyed by the idea of more monitoring and more doctors appointments. when it came down to the last few weeks, however, all that extra was comforting. but again, i never really thought for one second that we might actually lose another child. i felt a bit more stress towards the end when a few test results came back with possible issues that were similar to what happened with jesper. but still, they were just general concerns not genuine, heart-stopping fears.

there was, however, a moment with willow when my general concerns became something more.

at some point on friday, time is still very hazy for me on this subject, i finally asked for an epidural and we agreed to start pitocin. i am under the impression that the epidural took and hour and half to actually get in (that would be at least 5 attempts at an epidural, for those interested). i am also under the impression that when they were finally successful getting it in, i actually lost consciousness for some time because my blood pressure bottomed out. after regaining consciousness, i am aware of the nurse looking for willow's heartbeat for what felt like forever. i think it was at least 15 to 20 minutes that she kept looking and looking with the external monitor, but she never could get the baby's heartbeat to show up on the monitor. in all the happenings in the room at that moment, this is the one thing i became focused on. she was quietly searching and not finding. i was still having conversations with various people, but part of my brain was focused on what she was doing.

after a while dr. combs said "we are having a hard time finding her heart rate and we'd like to do an internal monitor." the response in my head--it may or may not be what i said--was "hell yes. please." because at some point in the quiet searching my general concern became a very clear fear. there isn't much that i remember clearly from her delivery, but i remember this.

**please find her heart beat. i cannot lose another child. this cannot be happening. find it. find it now.**

i will probably remember that thought and that feeling for the rest of my life. it was so absolutely clear to me. people say, "when such-and-such happened it was as if the whole world stopped." that's what that moment was for me. someone could have been screaming in my ear that the hospital was on fire, and i would not have heard them. i was totally focused on this instant, stabbing, abject fear.

thankfully, when they got the internal monitor on, her heart rate was just fine. and with it they were able to see the W's she was exhibiting. (W's are supposed to be the "classic" sign of a nuchal cord--ie, the cord around her neck. so in a way it was good for that, too. we were forewarned on that front.) so my fear was followed by utter relief.

another, finally

it has been a while since i posted, but i can finally report that we are pregnant again. after about 16 months of trying. my fifth pregnancy. my last pregnancy.

we had done clomid and a trigger shot the cycle we got pregnant. i took an HPT at 8 dpo, just to see if the trigger shot was still hanging around. very faint positive, so i knew that it was. couldn't get my bloodtest until 11 dpo at the earliest. so sunday morning i pee'd on a stick. 10 dpo. every other HPT i'd taken at 10 dpo after a trigger shot was stark white negative. this one had a very, very, very faint line. it showed up after the time limit. i debated if it was an "evap line." but both jeff and i agreed that it was definitely a pink line. ok, so we wait and test again the next day. i called my doctor in between taking the test and the line showing up. "i'm not pregnant, again. we're sad. and getting very, very discouraged." we were discouraged. on the verge of calling it done--for good. can't take much more of this. she said, it's still early. asked if we wanted a bloodtest. we said, we'll test again tomorrow and call then.

so i took another test on monday morning. this time the line was darker. this time it was pink without a doubt. this time it showed up within the time limit. this time i was sure it was positive. but somehow still doubted it. so we called to order the bloodtest.

HPT and bloodtest on tuesday both said positive. it's official. we got pregnant! dr. C was thrilled to tell me i was wrong.

i was so happy i could hardly contain it. i had already called my parents on sunday or monday and told them that we had a "tentative positive." jeff wanted to wait to tell people, but as usual, i can't seem to wait. he's cautious, i'm excited. so i started slowly telling people close to me.

we had our first ultrasound on October 10th. it showed that we were having twins. panic was my close friend for about 24 hours. so many BIG changes. we were ready? what exactly did it all mean? a bigger car. more stuff. more concerns about how nate would react. more concerns about nate basically losing his mom for a long time in order for her to care for two babies. not to mention, pregnancy and health concerns. and having to pick an actual doctor now. but not just any doctor. a doctor who could understand the complexities of the situation and not want to automatically cut me open just because there are two babies. i was stressed out, to say the least.

we had a second ultrasound on October 19th. it showed that we were once again having only one baby. i think the first words out of my mouth were "oh, thank god." so much stress was instantly gone. but it was replaced by another nagging feeling.

since we are having to inject 100 mg of progesterone in my butt every other day, we would have no idea if something went wrong. as demonstrated by the vanishing twin. that's why we did the first ultrasound. and after the second ultrasound is when i really started to worry that we would not, in the end, be bringing home a baby. again.

i ordered, and have already received, our rental doppler. it arrived a few days before the 10 wk mark. i was able to find Nate's heartbeat at 10 wks, so i was hopeful but still reserved about this baby. keeping in mind that because of the twins my uterus got bigger faster than it normally would. but now that we are back to only one baby, it would seem logical that that growth would sort of plateau for a while. plus, the remaining twin is actually the lower of the two. i tried to find heart tones one night but couldn't actually hear anything. the doppler seemed to pic something up, but i simply couldn't hear what it was reading. so we decided to wait a few more days to look again.

we had our first "official" prenatal appointment with SP, our midwife, on November 1st. we had a really laid back appointment. do you want to weigh? do you want to pee in a cup? do you want a blood pressure? yes, no, yes. we did a GBS swab--better to know the answer on that early so we can deal with it. and we were actually able to hear a heartbeat. at exactly 10 weeks. i was surprised, happy, and relieved. now i know that things seem to be going ok. and now i can check whenever i want to without resorting to an ultrasound and regardless of the injections. and that's the whole point of the doppler. to make me comfortable.

we also had a consult on November 1st with a family practice doctor who we were hoping would be willing to "follow along" this time. i really don't want to get to that 40 week mark and have to scramble around looking for a doctor who is willing to take my case. Dr. F was great. very laid back. we told her that things had changed--originally we had made the consult appointment when we were having twins. we weren't having twins anymore, we were returning to our midwife for care and planning a homebirth. but we also expained Jesper's death and the plan with Nate. we told her we would be seeing a perinatologist, as usual. and that the plan would probably be similar to that with Nate. 2 level II's in mid and late pregnancy, BPP's at the end, and induction at 40 weeks. she's on board. says, "oh, we do that all the time." ok, news to me. she said we don't have to see her until 34 weeks because we already have so much care involved. so that is done. and i'm relieved.

and now we can fall into the miraculously mundane days of a normal pregnancy. happy.

testing . . . can you see those lines?

this and that #1

so, i called the hospital to complain. they are in the process of making excuses and passing me from person to person. i don't expect anything to change. ever. but at least i said something.


on friday my eggie was ready to go, so we did the trigger shot again. though after that i have no idea when i actually ovulated. i expected two things: ovulation on saturday without the shot and major ovulation pain with the shot. i don't know if i ovulated saturday, i suspect so, but since i missed my alarm on sunday morning i will never know for sure. and i didn't get any ovulation pain that i remember, so if it was there it wasn't much. now, i've asked and the o-pain is not a phenomenon for everyone all the time. so it could just be this time that i didn't have it. who knows. at any rate it was another unsuccessful month.

beyond that i have nothing profound to say tonight, and the laundry is calling me.