Flotsam

Last night was awful, and I would probably write a detailed post about it were my eyelids not being fried by The Mag (all of the capillaries on my very white, clear-lashed eyelids have broken and my eyeballs are boiling. I have never looked more beautiful). The nurse who started my IV yesterday morning warned me that The Mag might make me feel I was being burned from the inside out, and unfortunately, it turned out to be rather an apt description. Computer screens exacerbate the problem, so this will be brief-ish.

For now, yes, Ames’ water remains broken, but I am stable, and on Magnesium and IV antibiotics. The doctors are hoping they can stave off infection/labor long enough to buy Simone a couple of weeks. They can’t do a transvaginal ultrasound or cervical exam because of the infection risk, so we are more or less in a semi-blind holding pattern, or what they call “expectant management.” They will probably take me off The Mag tomorrow, and start me on Nipefisomething. I can’t look up the correct spelling, and Scott will have to post this entry, because I am in my new room in the antepartum wing, where I will remain until the babies are born. And this room has NO WIRELESS. My old room had wireless, but this room, designed for women on long-term bedrest, has none. (There has been mention of “broadband wireless cards” that may be purchased, but I have a Mac, and Scott says they are not for Macs. Is this true?) Scott can pick up a stray wireless signal if he presses the laptop against the window, and in this way he can post things for me and download my email, but if anyone a better idea, for a homemade antenna maybe, please let me know.

We are holding up. Simone is monitored three times a day, and she hasn’t shown distress, though I worry every time she is off the monitor. She doesn’t move much because of The Mag, but on the Mag I have only a couple of contractions an hour, so until the crucial 24 hours since my last steroid dose have passed, I will merely fret and poke at her. I have no fever, despite the boiling sensation. So things are what passes for good, now. I wish I had a better idea of how much time I am likely to have now that I have ruptured—not that knowing will change anything, but still. Anecdotes, whether encouraging or not, are welcome.
I hope I am here a long time, and yet (selfishly) I am a wee bit nervous. They loaded me up with a maximum dose of sleeping medicine last night, a dose eight times that I have successfully used for sleep in the past, and I managed only the occasional 40-minute doze. I have barely mastered the art of sleeping in my own home, so I expect to be seeing trails and hallucinating Hugh Laurie within a few days of being hospital-bound all night.
I am simultaneously exhausted and on the edge of my metaphorical seat. My dear friend described this pregnancy as having turned into a sort of zombie movie: one improbable horror piled upon the next so that you find yourself thinking fondly of the time—was it just 20 minutes ago?—when less than 25% of the cast had been killed off and you still had your muscle shirt and your left hand. She said it much better, but trust me, it was exactly right. I should maybe mention that I have always hated zombie movies.

I hope to be able to write more after they turn off The Mag tomorrow and I feel less like…well, like I do now. But until then, thank you all. And those of you I know locally who offered visits? I just may take you up on that, as a stiff upper lip is so much easier to maintain with company.

Apparently Simone never took Logic for Neonates, because despite my last post I woke this morning to a small gush of fluid and brown discharge, and I am typing this from a hospital bed under the influence of Magnesium Sulfate.
“The Mag,” they call it. I could call it other things, but I will refrain, because I am a Lady.

Testing indicates that my water did not break. Thus I am assuming the clear liquid that soaked my undergarments was bathwater formerly detained behind some internal crevice. Please do not disabuse me of this notion by suggesting, as my husband did, that I may have wet myself. For the record, not even the nurses were rude enough to suggest such a thing.

Unfortunately the news is not all good. The brown discharge seems to give everyone pause. And, most troublesome of all, my Fetal Fibronectin test came back positive (too tired to explain, please Google). Add to that the fact that my cervix is still soft and now “short” (woefully unspecific—I blame The Mag for my lack of pestering) and you have Alexa, admitted to the hospital for at least the next two days, with vague rumblings about the possibility of an indefinite stay. I am still having contractions on The Mag, but they are intermittent.

I received my first round of steroid shots for Simone at 8am this morning, and will receive the second dose tomorrow, exactly 24 hours from the first. Simone has had a few heart rate decelerations but seems to be doing very well, though of course she is grounded. She has attempted to ingratiate herself by staying on the monitors (mostly).

I have gotten terribly behind on email, and if you have written to me recently—or even demi-recently, who am I kidding—and have not received a reply, I apologize. I read every email and comment, check for them umpteen times a day (much easier to read flat than to type flat, though I am working on it), and my next post was to be one I am working on in my head about how much these messages mean to me, and some changes they have wrought in my outlook. I really do intend to respond to people eventually, but at the moment everything seems difficult. Physically, typing is hard to do while flat with an IV in one arm and a blood pressure cuff on the other, especially given the fact that The Mag makes me disinclined to move. Emotionally I am exhausted, and—despite the breezy tone of this post—scared witless.

For the record, this is how I handle crises, situations in which much is at stake and I have limited control. I attempt, sometimes more successfully than others, to soldier my way through with only my tattered denial and an impressive arsenal of bad puns. I have a hard time diffusing sorrow this way, but fear is different. I do not mean to offend anyone, only I am fairly certain that were I not being glib I would be hyperventilating, and I have no paper bags handy. My apologies.

Please continue to hope for us, and I will update when I can.

I have started writing updates several times in the last few days, but I can’t seem to sustain a mood long enough to complete one. By the time I finish typing an entry it is no longer an accurate reflection of my mental state. I may start a relatively positive post about Simone’s continued nurse-baiting, but halfway through I am not feeling positive, rather I am bitterly contemplating the woman I heard complaining about having a C-section. I start writing about that instead, but then I am suddenly overcome with sorrow and cannot see the point of writing anything at all—in fact, how about a nap? And maybe some incoherent sobbing?
The only constant, really, is fear. That seems to be here to stay.

And so am I. At my appointment yesterday I was officially put on bedrest for the remainder of this pregnancy. Probably this is just as well, because while my contractions had slowed with stricter bedrest and increased hydration, my two appointments that morning were enough to get me contracting almost constantly, and even now I am at about five of the stronger variety an hour. The stronger variety being the sort that begin with the feeling that someone has crushed my windpipe, causing me to cough and splutter to catch my breath while Simone is forced to reenact the trash-compactor scene from Star Wars.

My first Fetal Fibronectin test is next Monday, and if it is positive I will be given the steroid shots and admitted to the hospital for a few days. If it is negative my cervix will be evaluated every which way, I may or may not be given some medicine, and I will be sent home to twiddle my thumbs (while lying down, of course) until the next Fetal Fibronectin. The reason I have not been given medication for contractions already is because my peris are not sure the contractions are responsible for my mushy cervix, seeing as how I usually have fewer than six per hour, and bedrest seems to be keeping them controlled. Of course the minute I get up, my uterus goes mad, hence the continued lying-flatness.

Bedrest isn’t particularly glamorous, or even pleasant, despite the fact that I am a fan of both “bed” and “rest” individually. If my life were the thirties-era movie I have long wished it were, I would be sitting in a round, satin-sheeted bed in marabou slippers and a fetching bedjacket, frequently summoning tea and mashed potatoes via a tasseled bell-pull hanging from the canopy. In reality, unfortunately, I am propped awkwardly on the couch in a milk-stained Cramps t-shirt my husband purchased at the age of fourteen for a date with his first girlfriend. Around me are scattered the crumby remains of the peanut butter sandwiches that constitute my only sustenance. And the ill-timed writers’ strike continues.

Despite all this, I am hoping fervently to be similarly employed for at least another two months, while Simone grows fat and healthy and thinks up new, creative ways to remain the bane of labor and delivery nurses throughout the metropolitan area. I want her born with pink, expandy lungs and nary a complication of prematurity, as close to term as possible before my uterus tries to kill her.
The other reason I hope not to give birth in the too-near future is that I can’t yet imagine what that day will be like. The second appointment I had yesterday was with the hospital grief counselor, to talk about what I want to happen when I give birth to Ames and Simone. It was brutal, and while I am supposed to be “thinking about” the issues we discussed and making decisions, instead I shoved all the paperwork in my purse and haven’t looked at it since. I tell myself I will look at it when I am ready. But how do you get ready to contemplate giving birth to a live daughter and a dead son within moments of each other? Does anyone know? Because I can not see how to begin.

It is always something, but rarely the something you expect. Don’t you find that to be true? I expected another first trimester miscarriage, and when that didn’t happen, I shifted my morbid focus to preterm labor. I read studies and memorized statistics. Now I keep thinking I prepared for the wrong thing. I didn’t prepare for this. This particular tragedy never occurred to me, was so far from my mind that when the nurse couldn’t get a picture of cardiac activity on the ultrasound yesterday, and left to get the doctor, I thought my baby was merely uncooperative and sleepy. He was in a strange position, down by my cervix, his little elbow and shoulder resting there, his arm over his head.

They tell me he died maybe three days ago—a Friday. They point out the small accumulations of fluid in his chest, the thickening of skin around his brain, his swollen umbilical cord, bloated and looking, I think, like link sausage, or DNA. Signs that he has been dead for more than a day. Two weeks ago he was “ideal.” They checked his heart, his brain, his kidneys, all of his baby parts, and everything was, they said, “perfect.” It just goes to show you. I don’t know what, exactly, but something about counting your chickens, or how hope is a winged thing that is always flying into your windshield.

I don’t think this post is going to make a tremendous amount of sense, which is fitting somehow, because none of this makes any sense to me at all. I miss my baby. His name was Ames. I wasn’t going to give the babies their names until they made it to viability, but I changed my mind. Ames was a good baby, he deserves his name. My poor little boy. Now, in the place I thought I felt him kicking, I can feel his sister. I wonder whether I ever felt him at all.

Last night a grief counselor called me to set up a time to make a birth plan. I am confused until she explains that I will be delivering both babies, though Ames will be only a pound and will have undergone some euphemistic changes. She tells me I might like to start thinking about whether I want him buried or cremated. Frankly there are few things I want less to think about. I would like Ames to be born live and squalling and covered with whatever disgusting substance babies are born covered with. That was my birth plan.

Usually in these cases they never find a cause, or so they tell me. They will analyze the placenta, because sometimes there is a problem there. They will check his chromosomes. But probably it will remain a “mystery.” I think “mystery” is a poor word choice, personally, because it makes it sound intriguing, and there is nothing intriguing about a dead baby. I am assured his death was caused by nothing I did, but this does not stop me from asking about every medication I have taken. I wonder about the days I forgot to take my baby aspirin. I wonder whether it was weaning off the prednisone, or being on the prednisone in the first place. I wonder how I am supposed to believe this has nothing to do with me when my body has failed four consecutive pregnancies. I wonder about a lot of things.

I hope it is not distracting, this writing in short paragraphs. I am not quite myself, and linking things together in a long entry, with a narrative, is beyond me at the moment. Probably you will be hearing a lot from me this week, because I am on modified bedrest, and it is very quiet here, and Scott and I don’t seem to know what to say to each other just yet.
You are always here for me during difficult times, and it means so much. Yesterday, after the ultrasound, the nurse left me alone to call Scott, and after I made that call, one of the worst I have ever made, my next impulse was to see if the medical records computer on the table could connect to the internet, so that I could post here. That sounds odd, but there you are. Your support has held me up.

A year ago, to the day, I was in beta hell, waiting for confirmation that my third pregnancy was doomed. The January before Scott and I had nearly separated over the question of whether to pursue fertility treatment. The January before that was my second miscarriage. January is a terrible month. I am terrified that this month is not done with me, that I will lose my little girl before the end of it. On January 25th I will be 24 weeks—the barest edge of viability. Ten more days.

They tell me there is a good chance that Simone will be fine (that is her name, Simone—she is a good baby too) but, now, how am I to believe that? How? I am on modified bedrest because I have been having a lot of contractions. Monday’s appointment had originally been scheduled for this Friday, but I moved it up because of the contractions, and an increase in discharge, and my general impatience. The contractions probably started when Ames died, though of course I didn’t know that at the time. Because Ames is Baby A, and is nearest to my cervix, there is a concern about preterm labor, or infection, or god knows what else.
“It is better when the upper baby is affected,” said my peri. Better.

Simone is transverse across the top of my uterus, kicking and wiggling obligingly. She waved at me on the ultrasound, and then opened her tiny mouth. I saw her eyeball, her chin. I just need her to live. Please. My dear girl. Sometimes she kicks hard enough that I can see it from the outside. I wonder what it is like for her in there, now. I am carrying one live baby and one dead one, and if I am very, very lucky, I will continue to do so for 14 more weeks. It hurts to think about.

They took blood yesterday to test for clotting factors, and warned me that having so much “non-living tissue” in my uterus can cause clotting issues that may endanger me and Simone. They will keep checking for the next six to eight weeks—after that “the risk is minimal.” Six to eight weeks.
I haven’t yet reached my peri’s danger-threshold of more than six contractions an hour, and yesterday my cervix was long (on transabdominal ultrasound). But I can’t relax, and I think I will call tomorrow and ask to sit on the monitors for a bit. Sometimes my belly stays so hard for so long I can’t tell if it is a contraction or something else. And six seems like such an arbitrary number. What if I am having six contractions an hour and can only feel four of them? I need to find out whether it is too late for P17 shots to calm my uterus. I need to buy a thermometer. It is hot in my apartment, and I am always overwarm, but now I am terrified of fever signaling infection.

I need a plan. I think we made one yesterday, but I don’t remember much of it now. I remember they promised to monitor me closely. I remember that starting at 28 weeks, should I get that far, they will do weekly biophysical profiles, and if Simone shows any signs of distress they will deliver. I remember they said she is likely to be born early, and I remember worrying about lung maturity, because of my gestational diabetes, and I remember that when I thought of my gestational diabetes I felt like screaming, because how many more ways can this pregnancy be high risk? And I remember the peri telling me that if I managed to get to 36 or 37 weeks they would do an amnio to check the lungs and deliver me then. But there are so many days to get through before 36 weeks, and information about outcomes is scarce. If any of you know of anyone who had a similar story, please write and tell me. I am starved for information.

And I am angry. I suppose that is to be expected, but waiting for the elevator after everything I saw another pregnant woman and thought bitterly that probably everyone in her body was still breathing, and probably she didn’t have two overflowing sharps containers on her counter, either. Probably she wasn’t still throwing up hard enough to cause nosebleeds, and probably her hair always does exactly as she asks. I am glad I don’t believe in god, because I think I would have marched straight to the nearest crossroads and sold my soul. I miss my baby, and it isn’t fair. Many of you have lost babies, and it isn’t fair. So many people want children and can’t have them, and that isn’t fair either. I demand that my other baby live. I have had just about enough of this.

Monday night I attempted to attend a class for expectant parents of multiples. Unfortunately, halfway through the evening I had to excuse myself to projectile vomit in a hospital bathroom stall. Almost 22 weeks and still not done puking, Zofran or no.
Truthfully I was almost relieved at the excuse to beat our hasty exit, as I am just not ready to discuss birth and baby care. If I make it to 24 weeks I will start thinking about accumulating bulb syringes and a crib, but until then I am merely focusing on getting the Science Babies—hell, all three of us—to viability intact.

Lately I am like the little girl with the little curl, if you know what I mean. Much of the time I am my usual delighted (and delightful) self. I eat whole meals, I watch television, I give the babies fond little lectures about how when Biggie promises to “make it hot, like a kettle get,” he is utilizing a simile (it is never too early to learn about figurative language, you know). I am, in all respects, the pre-holiday Alexa, overawed with every aspect of her life and giddily contemplating the future.
And then, occasionally, something misfires, and I lose all grip on my rational mind. Those instances, when they come, continue to level me with their breathtaking awfulness, though happily they do not come as often (nor linger as long) as they once did.
Last night Scott upgraded our computer’s RAM, and as he explained to me what RAM is, exactly, I decided that my primary mental problem is that I have insufficient RAM for the quantity of data (emotional, physical, practical) I am attempting to process. This has happened from time to time in the past, and I generally react the way you might if your computer had such a problem—I close a program or two, metaphorically speaking. Alas, I am now faced with a situation where it seems there are simply no extraneous programs running. And my brain, unlike my Mac, is not easily upgradeable. The RAM I have is all I get. And thus ends the nerdiest paragraph ever typed.

But while the past two weeks have been tumultuous ones, they also contained my favorite moment of pregnancy thus far, the moment Scott was first able to feel a kick from the outside. I wish you could have seen his face; it lit up like a flare in the dark. This particular kick was courtesy of my dear boy, who is head down on my left side and has taken up the study of Morse code. His sister, on the other hand, has positioned her placenta between herself and the outside world, for privacy (I forsee a surfeit of poorly-lettered KEeP OUT! signs in my future). Since that first startling thump I have been able to feel movement in a more organized and baby-appropriate way—that is to say distinct kicks rather than the vague impression of subterranean scurrying I had before. This seems more congenial somehow, and less like I am housing a sneaky, abnormally large tapeworm instead of two human babies. Feeling my children, whom I will presumably one day assist with homework and entreat to put on a jacket, for heaven’s sake, kick me with their ACTUAL FEET defeats all superlatives. I have been told the novelty will wear off, but I don’t see that happening anytime soon.

I have been looking at the pictures taken two weeks ago, at my 20 week ultrasound, and no matter how diplomatically I try to view the evidence, there is no denying that the Science Babies are exceptionally handsome.
See for yourself:

Boy (Baby A, also sometimes referred to as Stampy):

Girl (Baby B):

I, on the other hand, have reached a size that apparently entitles strangers to LAUGH OUT LOUD at me before faux-sympathetically asking how I’m feeling (thanks a lot, random lady). I think this is due to my short stature and the fact that I have gained no weight anywhere but out in front, in the fortress the babies have constructed from milk, tortellini, and sausages. The last picture I have was taken a week ago, and sources close to the subject (read: my husband and a trusted friend) assert that I have “really popped” since then.
So this…

…is me before this week’s growth spurt.
I will not be posting an “after.”

I have been avoiding you. Several times in the past week I have thought of posting something glib and amusing, but I couldn’t bring myself to do so—I do try to be honest here, and honestly? I am not doing well.
Lately I have taken to writing this entry in my head as I go about my day, only to sit down at my computer and lose my nerve. If you are still trying to get pregnant, this may not be the post for you. May I suggest instead a Google image search for “baby goat?” You won’t be disappointed.

****

I can’t remember for certain when it started, but my guess is Christmas Eve. I think at the beginning it was some combination of weather-induced house arrest during the darkest pit of a Minnesota winter and too many days off work with nothing to do but wander the dim corridors of my own mind. It began with a constant low-level anxiety that soared into a panic attack if I dared take a midday nap (an odd phenomenon I have experienced before, waking from a nap into anxious despair). Going back to work helped, a little, but then it was the weekend again, and things disintegrated rapidly into profound, constant anxiety with the occasional panic attack and crying jag. I started having trouble eating and began to worry over the fact that while I have had only one abnormal sugar since being back on the Metformin, I am not eating nearly the amount of food required by my GD meal plan, making the time before meals fraught as I scramble to think of something, anything I can bear to consume.
During all this, Scott was sparring with our upstairs neighbors, a pair of young, loutish drunks who moved in recently and have taken to playing bass-heavy music and tromping about at all hours of the night. Scott called the police once or twice, and slipped into a funk of his own, deciding we should move as soon as as our lease is up—perhaps buy a house, now that I have decided to stay in the Twin Cities for grad school. The talk of moving two months after giving birth to twins nudged my anxiety further skyward, and I resorted to taking a dose of the anti-anxiety medicine I had managed to avoid all pregnancy long (though I have continued my Zoloft).

Over the weekend things went from anguished to anguisheder and Scott rushed home from work to comfort me during a particularly bad spell. Seeing him worry makes me feel terrible, and I think I have said “I’m sorry” more in the past week than in the rest of my life combined.
Monday morning was my level II ultrasound, an event I had been looking forward to for weeks, but which I found difficult to enjoy over the nauseated thrum of panic behind my sternum. For parts of it I felt strangely detached, and horrified at myself for feeling such detachment, though eventually I was able to get into the spirit of things, laughing at the antics of my wiggly babies and marveling over their perfect feet. My peri visit after the ultrasound helped a bit as well—the Science Babies were pronounced “ideal,” and my weight gain has miraculously caught up at 18 pounds, despite my lackluster appetite.

But back at home, things veered back to awful, and that night I reached my lowest point:
Panicked and desperate to regain the bliss I had felt only a week before (had it only been a week?) when I started feeling the bubbles of fetal movement, I took out my new ultrasound pictures. To my horror, looking at them resulted not in a warm, maternal feeling, but an immediate wallop of nausea and terror as I realized that currently residing inside my abdomen were two entire, separate-from-me human beings, for whom I was and would be completely responsible. They felt like strangers. And following closely upon the terror of that reaction was a wave of shame and self-hatred the likes of which I have never felt before. How could I be afraid of my own babies? How could I be afraid of what I spent three years trying for? What was wrong with me? What if I couldn’t do this? What if this was a mistake? Could the babies tell how I was feeling? What if I am too anxious to take care of them? What if they hate me?
Cue anguished sobs. It was hours before I could bring myself to tell Scott what was wrong, and even then I couldn’t look him in the eyes as a refrain of “Bad Mother, Bad Mother” hissed through my head.

Yesterday was brutal, but last night the clouds parted briefly after I took another forbidden anti-anxiety pill. (Not exactly forbidden—I am allowed to take them for panic attacks now that I am out of the first trimester, but no one seems clear on how often is safe). I ate a large piece of cheese. Scott and I talked and laughed and went to bed early. Hope glinted distantly on the horizon. Alas, I woke to a slate wiped clean of progress.

So here is where I am today: I can’t eat, and am perpetually on the verge of tears. I thought the second trimester was supposed to be the even-keeled golden-period of pregnancy, and instead here I am, at twenty weeks, miserable and hating myself for it. A week ago I was wandering around in a happy daze, tapping my belly to get the babies to move. A week ago looking at a onesie gave me a thrill of excitement, instead of propelling me out the doorway of Target to hyperventilate in my car. I don’t know what happened. Rationally I know that the anxiety caused the baby-related panic and feelings of incompetence, but the anxiety is still squatting unwelcome in my chest, making rationality difficult to sustain. And I don’t know what caused the anxiety. I want desperately to believe that this is hormonal, as the last time I felt this way was was almost exactly a year ago (see this post), after a stressful chemical pregnancy. But in my darker moments I think that it might instead be some fundamental and insoluble insufficiency in my mental makeup.

Don’t get me wrong, in the past week I have had my moments of clarity, moments in which I snap back to myself long enough to pat my daughter’s head where it is wedged against my ribs or assure myself that this too shall pass, but they are only that—moments—and moments just aren’t cutting it right now.

I am terrified to post this, have in fact been staring at the “publish” button for over an hour. There is a lot of pressure to be happily pregnant, and after infertility, that pressure is enough to create whole fiercely glinting diamonds of shame. However, some very kind email from concerned readers is making me temporarily courageous, so here goes nothing.