Words to Live and Write by

I am willing to fall Because I have learned how to rise.

I craft Love from heartbreak, Compassion from shame, Grace from disappointment, Courage from failure.

I am among the brave and brokenhearted, and I am rising strong.

(credit to Brene Brown)

Monday, September 17, 2012

Our Pregnancy Story

  Our pregnancy story is not like most. Even in the beginning it was a struggle. I have Polycistic Ovarian Syndrome, which makes getting pregnant very hard. I am categorically infertile. Much like my biblical namesake, I cried to God for years to give me a child. I educated myself about the process - something much more complicated than "birds and bees." We used the medicine Clomid to aid us. Clomid causes menopausal symptoms as it "tricks" the body into producing extra hormones and hopefully ovulation. It is stressful on body and spirit and relationships, and can only be used under careful observation of an OB/GYN because it carries a risk of ovarian hyperstimulation.
    After eight months of Clomid, we were scheduled to take a break from fertility treatments. That's when I had my first miscarriage: January 2008. Needless to say, we were devastated.
  But Anthony found a good job, we moved out of our student apartment, and got our dog Ajax. Having a dog, we thought, was a lot like having a child, and we doted on Ajax. I quit work and became a stay-at-home "dog mom," mostly to reduce any outsides stresses and focus on fertility treatments and appointments.
  That summer, we resumed Clomid treatments. I got pregnant again. At the first appointment, around 10 weeks, the ultrasound showed no heartbeat--a blighted ovum. Two days later I miscarried: August 2008.     This time was worse. The physical pain had me doubled-over and in tears for 24 hours before we decided to go to the ER. Recovery took well over two weeks, and I was forced to confess to family and friends what we were struggling with.
    It was so hard to watch my siblings, my friends, and everyone at church get pregnant and have babies like it was nothing. I couldn't understand why God would punish me like that.
    That Christmas, the recession hit hard and Anthony was laid off. By March, we'd moved to Texas to live with my brother. I found a full-time job, but Anthony was not so lucky. It was hard to live with our niece and nephew and not feel constantly the pain of our own infertility. When my parents wanted us to house-sit while they served a two-year mission, we agreed happily. It was wonderful to have privacy again, even if the house wasn't ours. Anthony found work again, I taught Seminary, and we called Ajax our "substitute child,"
    But the heartbreak was real and constant. We shared so many tears over dreams that seemed lost. We continued to wait, putting away a little money each month for a "baby fund." Still, it seemed hopeless until our first pregnancy miracle occurred: with my sister's help and encouragement, my younger brother and his wife donated enough money to cover the cost of our next fertility treatments: gonadotropin injections.
    For a week in April, every evening I would sterilize and fill a syringe with gonadotropins, plunge it into my pelvis, and cringe as I pushed the burning fluid into my body. My right ovary produced five viable follicles (we freaked out a little at the idea of quintuplets), and on April 27, 2011 we got pregnant, luckily with only one baby.
  We hardly dared announce it, but all our family were waiting to hear, and soon it was impossible not to tell because by May I was in the ER. I couldn't stop throwing up, though we'd expected that part, and I had a pain in my abdomen so intense that I couldn't walk or stand. It was the worst physical pain I'd ever known, but it was only the beginning. My right ovary, which had worked so hard to create a baby, was hyperstimulated. Three of the five follicles remained on the ovary as cysts, and as they grew and filled with fluid the pain increased. But due to the delicate nature of my pregnancy, there was nothing to do but wait.
  And so we waited. I loaded up on Zofran for the nausea and Vicodin for the pain, and somehow kept teaching Seminary until June, although I couldn't wear my usual heels and had to dart to the bathroom a few times to puke. 
Compare to the Yoda picture--they're identical, I swear!
  I was identified as a high-risk pregnancy, so we had a lot of doctor's appointments and ultrasounds. We got to see the baby's heartbeat as early as May - a single glashing pixel on the ultrasound screen that meant life. The first picture we have is so tiny and blurry; when we looked at it just right, we saw what looked like Yoda, so that's what we nicknamed the baby .

  As summer came, the sickness got worse. I was throwing up at least six times a day, I couldn't keep food or liquid down, and it hurt to walk. So I spent most of my time in bed, keeping the trash can nearby and attempting to distract myself with reading. I used an early ultrasound picture as a bookmark to remind me why I had to suffer.

    Soon we had a collection of pictures showing Yoda's face, and every ultrasound showed my ovary was even bigger. It grew to 8 cm - a normal ovary is only 2 or 3 cm, and supported three large cysts. I got frequent comments from ultrasound techs like, "That's the biggest ovary I've ever seen!" and, "Wow, that must hurt."
  My first OB finally showed concern when I finished the first trimester weighing only 85 pounds. He suggested I drink milkshakes. I scowled at him. He said if we couldn't bring my weight back up we'd have to hospitalize me. I knew how expensive that would be, so I did my best to drink and keep down Ensure for a couple weeks. Anthony could only feel my ribs when he held me, but I gained just enough weight to keep me out of the hospital for a time.
  In July, we had another miracle: Anthony got  a new job which had much better health benefits. It was just in time, because my next ER visit resulted in a hospital admission. I couldn't even drink water without throwing it back up. They tried different anti-emetics and pain-killers and sent me home. I was wheeled back in the next day literally vomiting every five minutes. They tried new things for a few days, sent me home, and saw me come back only a couple days later.
  They tried putting me on steroids and Reglan next - a perfect recipe for a CRAZY Hannah. I had panic attacks ALL.THE.TIME. I couldn't calm down, I couldn't think logically. I was dramatic and crying, worrying over nothing, and suddenly desperate to be not pregnant. I was in constant, excruciating pain.
   Finally, they assigned me an OB: Dr. Leigh. Our eighteen-week ultrasound came - the big one. Dr. Leigh told us that the ultrasound technician would take pictures of every organ they could see and the doctor at the lab would look it over before sending us home. She said if everything looked good, we'd go home right away; otherwise, we'd have to wait while they figured out what was wrong.
    Anthony took a long lunch break so he could be there to see the baby and its gender. Yoda was a girl! That actually wasn't much of a surprise, since we'd both felt as much from the beginning of the pregnancy. Still, we were excited to see her little fingers, toes, and various parts in the ultrasound. I remember being so relieved when the tech focused on Yoda's spine - despite the poor nutrition I'd been getting, everything looked perfect.
    Anthony had to go back to work, so I waited on my own for the all-clear to go home. Except the tech came back in and said she needed more pictures. Then she left, only to come back with a different tech to take more pictures. Something was wrong. Eventually, they told me to go home and expect to hear from the doctor.
    Dr. Leigh did call, and told me not to worry (of course I was terrified); the placenta was growing in front of the cervix (placenta previa), which only meant I'd need a c-section if it hadn't moved by the time I would deliver in January.
    She also said the ultrasound gave good pictures of my ovaries. My right ovary was the particular problem. It was 15 cm long now - five times normal size - and in danger of twisting. She recommended a laperoscopy to drain the cysts. How did tomorrow sound? There was a 5% risk of miscarriage with the procedure, but it should relieve the pain and resolve the hyperemesis, too.
    We went back to the hospital for the surgery. I was scared - for me, and for the baby. I didn't want to lose her. The day before surgery was the first time Yoda deliberately kicked me - just two really hard kicks, as if to say, "I'm here, Mom. I'm gonna make it. We'll be fine." I cried, and felt such hope from those kicks.
    I was still scared about the surgery but everything went fine. I woke up with the worst sore throat I've ever had from having a breathing tube down my throat. I also had two small scars from the laperoscopy incisions. We spent our 7th anniversary taking walks of slightly increasing lengths around the maternity wing. But Dr. Leigh promised I'd feel better in no time.
   When they sent me home, I was as sick as ever. Throwing up everything that crossed my lips. At 19 weeks, I weighed 12 pounds less than my pre-pregnancy weight. Dr. Leigh was concerned that it might be afftecting the baby, so she recommended TPN ("Total Parental Nutrition"), an intravenous fluid to provide all the nutrition I needed but couldn't eat myself.
     Another hospital visit - the nurses all knew us by now - and I had a PICC line inserted into my left arm. Starting near my elbow, it was an IV tube extending all the way to my heart valve. Every night for the rest of the pregnancy, Anthony would help me assemble a big bag of smelly, white fluid that would be pumped into my heart over 18 hours. I carried a backpack containing the fluid and a pump everywhere, covering the whir-click-whir noise with a pillow to try to sleep at night.
    Meanwhile, Dr. Leigh recommended I see a perinatologist about the placenta previa. He was not very talkative, but over several visits, I learned that what I really had was vasa previa: the umbilical cord attached to the placenta directly in front of the cervix. If I started labor, the baby's head would push on and rupture those membranes and she would bleed to death in a matter of minutes. That meant to avoid labor, I'd need to be hospitalized early and have a c-section at least one month before my original due date.
    Thus our baby was scheduled to be delivered on 12/20/11. The best news I'd received all pregnancy: I didn't have to do 9 months!
     The weeks that followed were torturous and slow. Over time, the TPN helped me regain minimal strength. I could walk to the bathroom on my own, but it hurt. Mostly, I was forced to sit all day (vomit bag close at hand) and try to pass the time. Mentally, I wasn't doing too great. I think my mind decided the only way it could survive the pregnancy was to temporarily vacate the premises - though sometimes I wondered if it had gone for good.
    The cysts on my ovary had not gone away, but almost immediately refilled, leaving me in the same condition as before the laperoscopy. I simply couldn't think beyond the physical pain and discomfort. There was only pain. My entire world was pain. Nothing else mattered but making that pain stop. Anything to make it stop. Literally anything. Throwing myself down the stairs, slipping in the shower, taking an entire bottle of painkillers - anything. Those thoughts were real and forceful; it was the most frightened I have ever been and I was frightened of myself. Except it wasn't me. The drugs and steroids and primitive survival mode my brain were in had turned off all the parts that made me me. I was terrified that I would be stuck that way permanently: always in the darkest abyss, never able to feel happy or light, or breathe deeply again. I lived with that terror for months. I clung desperately to Anthony's company. He couldn't get anything done because I would beg him to stay close to me. He was the greatest comfort I had.
    At one point, I remembered a Seminary lesson I'd taught about the power and influence of righteous music Since my thoughts were so dark, I thought singing hymns might help drive away the demons. It did! Amazingly, I felt dark presences leave, and peace and comfort fill their place. That's not to say I was suddenly bright and optimistic, but I was noticeably better. Anthony, again my hero, agreed to add hymns to our bedtime scriptures and prayers. We'd sing until I felt safe, or until my ambien kicked in and I could sleep; some nights took longer than others. Anthony developed a unique skill: he could sing in his sleep. He spent my pregnancy as exhausted as I did, and he would eventually drift off to sleep as we sang our 10th song that night. I always knew when I'd lost him because the words he sang no longer made sense. But he always sang with me, to help me feel better.
    Meanwhile, Yoda had discovered that she liked to kick. The stronger I got, the stronger she got, and she was enthusiastic! Non-stop, day and night, she'd kick my ribs, my bladder, anything she could reach. And she could spin around so fast that she could reach anything. She learned how to stick a foot or an elbow out - visibly an inch - from my belly and slowly slide it across the front of my stomach. I felt like I belonged in a science fiction movie. Anyone who watched me would see my hands constantly on my belly, pushing parts of Yoda back into place. When I tried to drink soda, she would flutter with glee. When I threw up the soda, she would stomp and punch as if to say, "Hey! I wanted that!"
    Just before Thanksgiving, the severe pains I'd been having in my ovary got worse. A LOT worse. We decided I had to go to the ER again, this time to St. Vincent's. After way too long in triage, I was admitted so the perinatologist could see me and decide what to do. While the doctors ran tests and ultrasounds and deliberated - all day - I was writhing in pain, nearly breaking Anthony's hand, repeating, "It hurts so bad!" and, "Help me!' Worst pain of my life!! They gave me an IV and a morphine pump: "Just push the button until you feel better, honey," I mashed that button for all I was worth, but couldn't mute the pain.
    Finally, at the end of the day, the on-call doctors changed. The lead doctor on the new shift came straight to my room and explained. My ovary had twisted and lost blood supply; the organ had died and it needed to be removed quickly before it became toxic. There was a chance the baby would need to be delivered, and at 7 months gestation, that meant a chance she wouldn't make it. But if we left the ovary in - well, things would be worse. Did I want to do the surgery? ("Hell, yes! Get that thing outta me already!") Things went fast then. We barely had time to call a few family members and ask them to pray for us before I was prepped and in the OR. Anthony would have to wait in the lobby.
    Waking  up from anesthesia was much different this time. I was still in the operating room; I could see a clock on the wall; and I couldn't breathe. Not at all. My body, having been so weakened over the past 7 months, couldn't shake the paralysis from operation. I remember the anesthesiologist pulling a mask away from my face and telling me to breathe. I couldn't. I couldn't move my lungs. I couldn't move any part of my body, even my eyes, to indicate that I was suffocating.
    Just as I started to black out, the mask was returned and precious air was forced into my lungs. Only to be removed again with a stern, "Hannah, breathe." I don't know how many times we repeated the exercise (later the anesthesiologist said he tried for two hours). Enough for me to wonder what it was going to feel like to die. Enough for the anesthesiologist to give up, sedate me, put a breathing tube in, and send me to the ICU.
   When I finally woke up again, I had three questions. I couldn't ask any of them efficiently - my voice was blocked by a breathing tube and my hands were tied to the hospital bed lest I panic and try to remove the tube. But a very sympathetic, tired nurse with purple hair understood me.
   Why did my throat feel funny? They hadn't removed the breathing tube yet; they would soon.
   Was the baby okay? Yes. (I couldn't help the tears that overflowed with that news.) Yoda had done fine. The nurse, Brandi, had been there all night just to watch Yoda's heartbeat in case anything happened. Although everything was prepared, my baby would not be delivered that night.
   Where was my husband? He had been pacing the lobby all this time. All he knew was that I was in critical condition. Maybe once the tube came out he'd be allowed to see me.
   So I touched my belly softly and thanked God and the angels that Yoda was alright. Then, for some random reason, I began counting backwards from 9, repeatedly, until they took the tube out. The first words I squeaked were, "I want my husband." I must have sounded like a broken record, because eventually Anthony was by my side, holding my hand. Honestly, I've never been so happy to see him. I'd almost died; he was the person I wanted to cling to in this life.
  When they transferred me back to the maternity wing on Thanksgiving morning, they had me hooked up to a morphine drip, a magnesium drip (to prevent contractions), and a blood transfusion. Actually, one transfusion wasn't enough, I needed two. I remember they removed my catheter and, stubborn me, I refused to use a bedpan. So the nurse brought a bedside potty chair over and she and Anthony helped me slowly get out of bed. As soon as my feet touched the floor and I shifted my weight onto them, I collapsed in their arms. It was ridiculous how weak I was and how many days went by in a blur before things got real again.
   But I healed. Slowly. They'd removed my entire right ovary, claiming it was as big and black as Anthony's head. It took away a lot of pain. But now I had new pains: recovering from major abdominal surgery (a 6-inch vertical slice down my belly) while a growing baby stretched and kicked the incision from the inside. When I could finally walk (just around the maternity wing) I felt like my belly might split open and let everything fall to the floor. But the stitches and staples held.
   Anthony spent every other night with me, sleeping on an uncomfortable window seat, being my strength. We started a countdown on the small whiteboard in my room: only X days left!
   December 20th finally came. Anthony got all suited up in white OR clothes. They unhooked my IVs and we walked down the hall to the OR. The spinal took no time at all. Behind the blue tent between my face and my lower half, I could hear the assistants ask, "Should we mark her?" (Normally a sharpie is used to mark where the surgeon will cut.) The doctor just laughed and said, "She's already marked." We were ready.
  Yoda was transverse. The doctors had to push to get her head down. It hurt so much I thought they were going to crack a rib! And I wasn't supposed to be able to feel anything.
    Finally, the doctor popped to the side of the curtain and said, "Look over here!" where he held a tiny, purple, rather perplexed baby. Lana. She hadn't cried yet. But knowing my Lana, she was just getting her bearings first, wondering why in the world we'd want to remove her from her comfy spot.
    She did eventually scream. I cried. I kept saying, "It's too much! It's too much!" Which, I guess, might be interpreted as "I'm overwhelmed by happiness." What I really meant was directed at the anesthesiologist: "I can't handle any more, just put me to sleep already!"
    Lana was born on 12/20/11 at 12:51 pm. She weighed 4 lb. 14 oz. and was 18 1/2 inches long. She seemed perfectly healthy - ten fingers and ten toes. We loved every perfect part of her.
    Looking into her eyes for the first time all I could say (and still say) was, "Thank you. Thank you for being my daughter. Thank you for being strong enough to fight through that hell of a pregnancy with me. I'm so happy you're here. Thank you."

Leave your thoughts and comments, please!