on helplessness

The past week has been hard and sad. For the past month I have felt like I was in a very fragile place but doing a pretty good job keeping it together. But needing this surgery, the invasiveness of having no control over my body (again) and everything surrounding it really brought me to a low place. I think it is also the holidays and being surrounded by babies and children and families, too.

When I lost N&A, I was really worried about the bitter and jealousy returning. There was a stretch of time during our infertility struggles when I felt very jealous and bitter of others' good fortune. The jealousy and bitterness was something that came from a very dark place and honestly made me feel pretty crappy about myself. It was something that felt destructive and I made a very conscious effort to work through it. I like to believe I mostly succeeded on this front.

In the aftermath of their birth & death, I was relieved that the bitterness and jealousy didn't return, or at least not in the way that I feared. I didn't want any baby in some abstract sense; I wanted them - my specific babies. Other babies felt irrelevant.

Passover was the first time I was subjected to babies and young children in large doses since our loss. It was much harder than I expected, not because I was jealous, but because it was such a visceral reminder of everything I can't do for my babies. A screaming baby in need of soothing is enough to get me wailing. Because the baby can be soothed. Because there is something her mother can do for her.

I never got to do anything, really, for my babies. It is the most helpless feeling I can imagine, I think, to give birth to a living baby to whom neither you nor medical science can help. To give birth to a living baby who by virtue of leaving your body is destined to die. Perhaps giving birth to Aminadav was in fact doing him a kind of favor because of his suffering - but again, I always come back to it - when I gave birth to Naava I killed her.

I never even held Naava. Sometimes I wonder if I lack basic maternal instincts. One day a couple of weeks after their death, our cleaning lady pulled me close and said "Maybe your soul wasn't ready yet to accept them."

During more rational hours, this seems like a hideous proposition - after all those failed fertility treatments, our first miscarriage, all that longing - my soul wasn't ready yet to be their mother? But why didn't I know instinctively to hold my babies, especially my living one? No one encouraged me or told me to. I was in shock. It all happened to so quickly. I will know better for next time. These are my alibis. But why didn't I just intuitively understand to do it?

I wasn't able to do anything physical for my babies in this world. I love(d) them and think of them constantly. Winter is over and the days are becoming long and hot. I do not think it will rain again. G-d willing we will somehow bring a living child into this world (though that seems to become increasingly daunting to think about with every new complication). But nothing is going to bring these babies back; no amount of magical thinking or new medical knowledge or regrets realized & examined.

surgery tomorrow

Wish me luck - this thing is supposed to come out tomorrow. We did a doppler ultrasound yesterday that showed this thing is taking up most of my uterus and has a fantastic blood supply. I think it is the blood supply that suggests my uterus is a ticking hemorrhage time bomb and is encouraging them to move before Passover. They actually won't be 100% sure it is placenta until they biopsy it - it could also be degenerating fibroid or something else. I learned something interesting and freaky today - you can have a molar pregnancy that coexists with normal fetus(es). One doctor proposed the possibility that this could be my case, but thankfully we've ruled that out. I hope I will have a good report tomorrow. It is very disappointing that tomorrow is when we were supposed to fly to the states.

a gray cloud

The last week has been tough. I have been feeling very frustrated and angry since my appointment with the surgeon on Thursday. I have so much I want to say not about me, but about my babies, and I have been having a very hard time concentrating and getting it out, which in of itself is very frustrating - it makes me feel like I am not honoring them properly. Disappointingly, this post is probably going to be mostly about me and my appointment last week.

When I left off last time, we were beginning to consider the advantages and disadvantages of the myomectomy, the fibroid surgery (which, for reasons I will not get into right now, does seem like something we will likely pursue before returning to IVF).

On Thursday we had the diagnostic hysteroscopy with one of the two doctors who does endoscopic gynecological surgery to see what the fibroids look like now and in order to make a decision about the surgery and to hypothetically schedule it. Instead, we found out that my uterus is full of retained placenta and it was impossible to visualize the fibroids.

This was really surprising to us since it was a potential complication that no one discussed with us and because I had actually already had a D&C for retained placenta immediately following delivery. Apparently, vaginal birth between ~20-26 weeks is a risk factor for retained placenta and the risk with multiples is even greater. Add in the fibroid, the placental abruption, and my failure to deliver Aminadav's placenta, and in retrospect, this complication is not terribly shocking, but it still really really sucks.

The plan now is to do an operative hysteroscopy to remove the retained placenta on April 22. Unfortunately, they can't also do the myomectomy at the same time, so we will need to wait for my uterus to heal from this first procedure and then do the fibroid surgery later on. And then heal from that. Remember that crazy idea my RE had about starting a new IVF after Passover? I am wondering if the joke is on me - perhaps we're talking about Passover 2013.

There is a small possibility that the retained placenta will come out with my next period. The doctor seems to think this is not terribly likely, or at least not terribly likely that it will all come out (this is actually really disgusting to be writing about, and probably pretty disgusting to be reading about, so I apologize). What is more likely it seems is that I will get a period and the tissue will become more "organized" as they say and as a result, take up less surface area of my uterus, which will hypothetically make it an easier procedure with lower risk of causing significant scarring or adhesions. This is apparently why we are waiting until April 22 (that and socialized medicine, which I actually have few complaints about).

Unfortunately, for as long as I am walking around with retained placenta there is the risk of hemorrhage. I have been reassured this risk isn't terribly high since I am not actively bleeding at the moment, but high enough that air travel, specifically transatlantic air travel of the variety we had planned for most of the month of April, is not particularly wise. There is also the secondary issue that no travel health insurance plan will cover us abroad (i.e in the United States) because of my current condition. (It is worth mentioning that one doctor said air travel would be fine, one doctor said not a good risk to take, and a third implicated it's a bad idea but said it's up to us.)

The one immediate thing I was looking forward to was traveling with Y to the states to spend Passover with his family in Miami and then our trip out to California and up the Pacific Coast Highway. We were both really looking forward to the change of scenery and alone time together. The plane tickets were purchased, the arrangements made, and we thought this trip was a done deal. We literally planned the trip in the recovery room after my D&C, which was just a couple hours after I delivered the babies.

This was supposed to be our escape from all of this horribleness and I am so sad that now it seems we can't even take this trip, or at least the California component is in great jeopardy - no consensus on Miami yet. It is really hard to keep my chin up - stuff just keeps going wrong and it is increasingly hard to believe anything will change. When the doctor mentioned the risk of hemorrhage all I could think was "Hemorrhage? Why not? Sounds like something that would happen to me." I hate being this downtrodden and negative about everything. Still waiting for this big gray cloud to lift.