Saturday, January 31, 2009
Reaching Out
Monkey and Noah's mom could use a lot of love right now. I bet she'd appreciate a hug or a hand to hold. Or maybe someone to just abide with her in her struggles.
Friday, January 30, 2009
I can't believe I'm even asking this
Well, it's tax time. I knew this was going to come up, at least for me.
Joshua was born still.
Jacob had cardiac activity. "briefly" is what the record said. They did not give me a birth certificate, but my understanding is that in my state if I baby lives for even a few moments, he or she is considered to have lived. Not only did I not get a birth certificate for him, the death certificates had the wrong names and (I think) the incorrect times of birth.
Does "brief cardiac activity" count? I'm not looking for a pat on the back here, if it doesn't I will let it go. I will. But if it does count as "life", Jacob should be counted on our tax return. It feels so morbid, saying, "so, does my dead baby get me a $3500 deduction, or what?"
I have a couple of people in mind whom I might be able to contact, though the idea of dealing with all this bureacracy fills me with dread. And it might be too late anyway.
Part of what touched me so much when my aunt lit those yarzheit candles was that she was remembering them, acknowledging them, their presences, their lives, however brief.
Am I just asking for trouble if I start asking the state to do the same thing? To make, at least Jacob's life, official?
I welcome your thoughts.
Joshua was born still.
Jacob had cardiac activity. "briefly" is what the record said. They did not give me a birth certificate, but my understanding is that in my state if I baby lives for even a few moments, he or she is considered to have lived. Not only did I not get a birth certificate for him, the death certificates had the wrong names and (I think) the incorrect times of birth.
Does "brief cardiac activity" count? I'm not looking for a pat on the back here, if it doesn't I will let it go. I will. But if it does count as "life", Jacob should be counted on our tax return. It feels so morbid, saying, "so, does my dead baby get me a $3500 deduction, or what?"
I have a couple of people in mind whom I might be able to contact, though the idea of dealing with all this bureacracy fills me with dread. And it might be too late anyway.
Part of what touched me so much when my aunt lit those yarzheit candles was that she was remembering them, acknowledging them, their presences, their lives, however brief.
Am I just asking for trouble if I start asking the state to do the same thing? To make, at least Jacob's life, official?
I welcome your thoughts.
Tuesday, January 27, 2009
I don't know what it is
I'm just so sad and weepy today. I can't shake it.
It's not just this thing with my brother. It just feels like everything.
I just want to feel okay. Even okay feels weird.
I'm so tired of this.
It's not just this thing with my brother. It just feels like everything.
I just want to feel okay. Even okay feels weird.
I'm so tired of this.
Monday, January 26, 2009
Lost
I just spent an hour trying to create some context of my relationship with my brother. We were close as children. We grew apart somewhat in college, and then since my mother died, it's been more and more difficult.
*****
For two days, I've been trying to write a post asking "why did I even give him the chance?" the chance to read my blog (I accidentally left a link in the word document) despite my request that he leave it alone. And he lied about reading it. And, as the fabulous and thorough JK discovered, he also linked over to C's blog and read his.
I sent him the document to give him the opportunity to try to understand what I've been going through the last year. The document was only about the first 2 weeks, but a traumatizing two weeks. Two weeks I doubt will be challenged as the worst two weeks of my life, including the loss of my mother.
I wanted him to see what I was trying to deal with, so if I was distant or if the only thing I could share with him was good news for my oldest friend, he might be able to understand. He might get the vision of me lying totally vulnerable in a dark room a a doctor I don't know tries to rip out the remains of my dead son's placenta. He might begin to understand what we went through trying to figure out how to decide what to do, how to give my son what he needed.
In P's email, he wrote a few sentences about how he was glad that I had a place to put all this "toxic" stuff and that I had found some community.
He just could not get past his own lifetime of shit to consider what those two weeks were like for me. And what it might take for me to recover from it. He thought only of his insecurity, about how no one appreciates him and what he does for the family. And that's what he wrote about in his email to me. That was the focus of his response. But all he could read was a few offhand negative comments about his behavior. And that would be if he read only the document I sent. C wrote more, I wrote some. So I guess this is my fault.
I asked for it, I guess. And I'm sure he would say that the blogs just confirm what he's known all along. If he could ever be honest about reading them.
*****
I have no relationship with my sibs right now. I don't feel like I can talk to A about this yet. I don't know when or how P and I will clear this up. Certainly I'm not going to lay this on my dad. Not yet, anyway.
I had been feeling better. C and I had a terrific fight and cleared up some issues that had been lingering. But I'm so down now.
It sounds so corny to say: I just feel so sad. Like I've lost my little brother. And once my sister has her child the distance will grow. It has already begun to.
Maybe I'm being dramatic. Maybe this post is too long and I'm getting maudlin.
*****
For two days, I've been trying to write a post asking "why did I even give him the chance?" the chance to read my blog (I accidentally left a link in the word document) despite my request that he leave it alone. And he lied about reading it. And, as the fabulous and thorough JK discovered, he also linked over to C's blog and read his.
I sent him the document to give him the opportunity to try to understand what I've been going through the last year. The document was only about the first 2 weeks, but a traumatizing two weeks. Two weeks I doubt will be challenged as the worst two weeks of my life, including the loss of my mother.
I wanted him to see what I was trying to deal with, so if I was distant or if the only thing I could share with him was good news for my oldest friend, he might be able to understand. He might get the vision of me lying totally vulnerable in a dark room a a doctor I don't know tries to rip out the remains of my dead son's placenta. He might begin to understand what we went through trying to figure out how to decide what to do, how to give my son what he needed.
In P's email, he wrote a few sentences about how he was glad that I had a place to put all this "toxic" stuff and that I had found some community.
He just could not get past his own lifetime of shit to consider what those two weeks were like for me. And what it might take for me to recover from it. He thought only of his insecurity, about how no one appreciates him and what he does for the family. And that's what he wrote about in his email to me. That was the focus of his response. But all he could read was a few offhand negative comments about his behavior. And that would be if he read only the document I sent. C wrote more, I wrote some. So I guess this is my fault.
I asked for it, I guess. And I'm sure he would say that the blogs just confirm what he's known all along. If he could ever be honest about reading them.
*****
I have no relationship with my sibs right now. I don't feel like I can talk to A about this yet. I don't know when or how P and I will clear this up. Certainly I'm not going to lay this on my dad. Not yet, anyway.
I had been feeling better. C and I had a terrific fight and cleared up some issues that had been lingering. But I'm so down now.
It sounds so corny to say: I just feel so sad. Like I've lost my little brother. And once my sister has her child the distance will grow. It has already begun to.
Maybe I'm being dramatic. Maybe this post is too long and I'm getting maudlin.
Friday, January 23, 2009
Disappointed
When I got the announcement that K was finally home with B and their kids, I cried. I also forwarded it to my family, as B and I have been friends so long, I thought they'd be interested.
My brother responded with an email that said something to the effect of "enough about K, what are you up to?"
I cut and pasted (and edited a little) the two weeks of narrative of the two weeks of hell, and emailed it to him, told him that I had been busy trying to deal with all this. I told him I had a blog (my huge mistake), but please not to do a search for it. I trusted him not to read my blog.
But he did.
There were one or two paragraphs in the narrative that were not kind in reference to my brother. To which he took offense.
He sent me this long email ranting about familiar issues he has with me and my sister, and talking about what he went did during the week he was here (acknowledging it was nothing compared to what we went through). He talked about stuff I knew, stuff I didn't know, about that week. How he dropped everything to be here, in the middle of buying a house, planning a wedding.
He took a week's vacation that he was supposed to used for his honeymoon so he could be here with us. So he lost a week's pay when he took his three-week honeymoon to Spain this summer.
Other stuff, too.
*****
I received his email when I was running out the door to take Stella to training class, scanned it, and told him that I thought I asked him not to read my blog and I would write more later. He wrote back saying he didn't read the blog, just the document I sent.
He lied. I just saw his activity on my hit analyzer from his work computer yesterday. He spent about 10 minutes reading my blog.
He lied.
My brother responded with an email that said something to the effect of "enough about K, what are you up to?"
I cut and pasted (and edited a little) the two weeks of narrative of the two weeks of hell, and emailed it to him, told him that I had been busy trying to deal with all this. I told him I had a blog (my huge mistake), but please not to do a search for it. I trusted him not to read my blog.
But he did.
There were one or two paragraphs in the narrative that were not kind in reference to my brother. To which he took offense.
He sent me this long email ranting about familiar issues he has with me and my sister, and talking about what he went did during the week he was here (acknowledging it was nothing compared to what we went through). He talked about stuff I knew, stuff I didn't know, about that week. How he dropped everything to be here, in the middle of buying a house, planning a wedding.
He took a week's vacation that he was supposed to used for his honeymoon so he could be here with us. So he lost a week's pay when he took his three-week honeymoon to Spain this summer.
Other stuff, too.
*****
I received his email when I was running out the door to take Stella to training class, scanned it, and told him that I thought I asked him not to read my blog and I would write more later. He wrote back saying he didn't read the blog, just the document I sent.
He lied. I just saw his activity on my hit analyzer from his work computer yesterday. He spent about 10 minutes reading my blog.
He lied.
Sunday, January 11, 2009
Loving
One day I'll write a post about how twice a year she sends me care packages filled with Jewish and NY goodies I can't get here, goodies from Za.bars, making sure to include lox spread for C. I'll write about how she sends me articles on topics I once mentioned I was interested in.
Someday I'll write a post about how she begins her notes to me "Suzi dear," and still remembers terrible jokes I made about cereal when I was 10 years old, still gives them a warm laugh. I'll write a post about how at every family gathering for a holiday meal, she will bring crunchy, raw, red peppers for me, because she knows I love them.
Today, I'll write just a few words about how, during our phone call today, after I thanked her for her recent care package, and she asked me about school, my dear Aunt L (Tia, as she prefers), asked how I was doing. I was sort of honest, that it's been hard, this time of year,
but I'm getting through. And she told me she lit yahrtzeit candles for the boys.
And I amazed, and touched, that she was thinking not just of me, on those days, but of my sons. She was loving not just me and C on those days, but Jacob and Joshua, too. Perhaps, if she remembered the words, she was saying the prayers in Hebrew as she touched the match to the wick of each candle.
And 2 hours after our conversation, I am crying as I think of it, and I think about my worry that my boys would be forgotten. Or, dismissed. And I picture of her in her tiny NYC kitchen, looking at each flame, and remembering them. Loving them as she loves me.
Someday I'll write a post about how she begins her notes to me "Suzi dear," and still remembers terrible jokes I made about cereal when I was 10 years old, still gives them a warm laugh. I'll write a post about how at every family gathering for a holiday meal, she will bring crunchy, raw, red peppers for me, because she knows I love them.
Today, I'll write just a few words about how, during our phone call today, after I thanked her for her recent care package, and she asked me about school, my dear Aunt L (Tia, as she prefers), asked how I was doing. I was sort of honest, that it's been hard, this time of year,
but I'm getting through. And she told me she lit yahrtzeit candles for the boys.
And I amazed, and touched, that she was thinking not just of me, on those days, but of my sons. She was loving not just me and C on those days, but Jacob and Joshua, too. Perhaps, if she remembered the words, she was saying the prayers in Hebrew as she touched the match to the wick of each candle.
And 2 hours after our conversation, I am crying as I think of it, and I think about my worry that my boys would be forgotten. Or, dismissed. And I picture of her in her tiny NYC kitchen, looking at each flame, and remembering them. Loving them as she loves me.
Tuesday, January 6, 2009
Evening Comes
I don't really know how to end this. There is so much that follows that I've already written about. If I think of it, I'll post a list of links.
I need to take a breath or two, now. Thinking about what I (we) just wrote, what happened, and about you. I have felt so alone. Even with you here with me. Writing this made me realize just what we went through. It has made me realize that no one, except C and perhaps my sister and father, knew the whole story. The Whole story. I have censored and edited, and really, most of what happened does not fit into casual conversation. Into any conversation. And really, I don't know that it's a story I could tell anyone but you. Not like this.
So now I may take a moment to breathe, a day, or a few days. I'm struggling hard again. School begins next week and I still don't have a plan. But Stella begins school, too and I'm hoping that the routine of day to day will help me ease my way out of this pit again.
Thank you for reading, and for abiding with me. I felt every hand on mine, every arm around my shoulder. I'm not sure why, but I'll leave you with this poem by Jane Keny.on, one of my favorite poets. It leaves me feeling something I cannot name.
Let Evening Come
Let the light of late afternoon
shine through the chinks in the barn, moving
up the bales as the sun moves down.
Let the cricket take up chafing
as a woman takes up her needles
and her yarn. Let evening come.
Let dew collect on the hoe abandoned
in the long grass. Let the stars appear
and the moon disclose her silver horn.
Let the fox go back to its sandy den.
Let the wind die down. Let the shed
go black inside. Let evening come.
To the bottle in the ditch, to the scoop
in the oats, to the air in the lung
let evening come.
Let it come, as it will, and don't
be afraid. God does not leave us
comfortless, so let evening come.
I need to take a breath or two, now. Thinking about what I (we) just wrote, what happened, and about you. I have felt so alone. Even with you here with me. Writing this made me realize just what we went through. It has made me realize that no one, except C and perhaps my sister and father, knew the whole story. The Whole story. I have censored and edited, and really, most of what happened does not fit into casual conversation. Into any conversation. And really, I don't know that it's a story I could tell anyone but you. Not like this.
So now I may take a moment to breathe, a day, or a few days. I'm struggling hard again. School begins next week and I still don't have a plan. But Stella begins school, too and I'm hoping that the routine of day to day will help me ease my way out of this pit again.
Thank you for reading, and for abiding with me. I felt every hand on mine, every arm around my shoulder. I'm not sure why, but I'll leave you with this poem by Jane Keny.on, one of my favorite poets. It leaves me feeling something I cannot name.
Let Evening Come
Let the light of late afternoon
shine through the chinks in the barn, moving
up the bales as the sun moves down.
Let the cricket take up chafing
as a woman takes up her needles
and her yarn. Let evening come.
Let dew collect on the hoe abandoned
in the long grass. Let the stars appear
and the moon disclose her silver horn.
Let the fox go back to its sandy den.
Let the wind die down. Let the shed
go black inside. Let evening come.
To the bottle in the ditch, to the scoop
in the oats, to the air in the lung
let evening come.
Let it come, as it will, and don't
be afraid. God does not leave us
comfortless, so let evening come.
Sunday, January 4, 2009
Lacuna
Hi everyone - this is Sue's husband, C. She asked me to guest-write the next part of the story - not so much because she doesn't think she can as because at this point, details get spotty for her in a way that they don't for me. She'll have stuff to add to this, I'm sure. [And there have been lots of details I've already written about. I added my thoughts and details in red and parens, like this. You all know about the "after" stuff, the social workers and forms. I'll follow up soon.]
Brace yourself. It's long and difficult.
So we end up at a hospital where they can actually, you know, do what they're supposed to. Not the fault of our local hospital, unsuited as they are for anything but healthy pregnancies and the sort of injuries one obtains as a function of being a college student. Everyone there expressed their frustration with the ridiculousness of the State Attorney General's ruling that nurses couldn't push drugs for a preterm delivery. The ugly intersection of personal morality and public policy. The doctor was more reserved in his opinion, but I definitely got the sense that nobody was a fan of the policy. Small comfort*, yes, but if I'd had people all disapproving and shit up in my face, it would have been even worse than it already was. This is a new mantra in our household: It can always get worse. It can always be worse.
[*I think C is being generous here. It was all I could do not to completely lose it at the local hospital. You know, that quiet before the complete freak out.]
So we're in the University hospital, in an exam room because they were exceedingly busy and didn't have a labor & delivery room open yet. Also, the wing was in the middle of being remodeled. The first doctor we talked to talked to us about the paperwork required by the state: Apparently, along with the whole "nurses helping with preterm delivery are performing abortions" thing, there was a requirement that women attempting to deliver their children preterm had to be counseled about the availability of "alternatives" and had gone through a 24-hour waiting period. Because apparently, so many women drop by the hospital to abort their babies on their way to their mani-pedi appointments. To this hospitals' credit, we never saw that paperwork. The doctor to whom we spoke said, in essence, that it was bullshit and appalling that we'd ever be asked to do such a thing, and they'd already filled it out and filed it. [Thank god.]
I know, based on Sue's last post, that you all have a sense of the many of the things that went wrong or badly. Not everything did. With only a few (notable) exceptions, everyone was sensitive and compassionate, and even in some cases where things did not go well, I got the definite sense that the choices that got made were made in an effort to make it as quick and (relatively) painless as possible for us. But there we were, in an exam room, a transitional room, Sue hooked up to a contraction monitor, waiting. [Waiting: for our last ultrasound, for a real room away from the hubbub.] A fetal heart monitor was audible from next door - someone's healthy baby, heart beating away. A nurse was nice enough to turn it down for us [after only one request].
Another doctor came in to talk to us about the procedure, all smiles and bouncy...until she read the chart and saw why we were there. She outlined the approach they were going to take: Push a shitload of pito.cin fast [in increasing doses] to kick-start labor. Get it over with and done, both to keep from prolonging an awful thing and to help keep her out of the OR. Sounds good to me. We'd already been left hanging once.
Sometime after this (my internal clock went completely to shit once we were admitted - windowless rooms, days of shock and uncertainty. Hospitals are a lot like casinos: You have no idea what time it is, your money vanishes faster than you ever thought it would, and you may very well walk out with nothing to show for it.), we were moved to a labor & delivery room. A small, cramped, old labor & delivery room. One of the un-remodeled rooms. They kept saying they'd get us to a better room as soon as they could, but it wasn't to be.
They were getting slammed, from the sounds of it. Mostly because we were surrounded by the sounds of women delivering, celebrating deliveries, fetal heart monitors, and happy families. At one point, I walked out into the hallway to use the restroom (we shared one with an adjoining room, and the other people kept forgetting to unlock our door when they were done in there) and my head was filled with the heartbeats of other people's children. They followed me down the hall and crowded everything else out of my head.
Sometimes, I think I can still hear them. I still get uncomfortable listening to ultrasounds or heart monitors on television. [I get just a twinge.]
More waiting. More waiting. MORE waiting. Apparently, the pharmacy saw the amount of pito.cin the doctor had requested and said "this can't be right", but didn't bother to follow up. Doctor was not happy about this. Sue's already talked about the epidural, so I don't have much to add, other than the only thing that even partially redeemed the procedure was Nurse Bob. The nurses were, almost to a one, amazing, but Nurse Bob deserves special commendation. His compassion and sensitivity and gentleness were immeasurable. He was one of the things that kept it from being worse. [He held me as I got the botched epidural; one small comfort.]
We were there a long time. I don't know how long. The pitoc.in had [sort of] started to work and then plateaued. Eventually, someone figured out that the line wasn't sealed right or something and she wasn't getting the dosage she should have been for awhile. A big puddle of pitoc.in all over the floor. Her family came and went in different combinations. I don't remember much of this anymore. I was mostly focused on Sue anyway. I remember they kept asking me if I wanted them to spot me while I took a walk or something. I couldn't imagine being anywhere else other than Sue's side.
They kept fiddling with the amount of anesthetic she was getting in the epidural because it wasn't spreading to one side well enough. [They also tried rolling me to one side, hoping gravity would help distribute the meds. It didn't.] Lots of sitting, waiting, talking to people, waiting for the drugs to kick in. This was not going to be quick. Finally, at some point, Sue was getting nauseous, from what I don't really remember. [I think it was the empty stomach. I hadn't eaten all day.] She'd been hyperemetic throughout the pregnancy anyway. She was given some phener.gan to help the nausea. It also pretty much knocked her out, as phene.rgan is wont to do. [I remember family members coming in and out at various times,but I think it may have been later than this, after the boys were delivered.] It must have been getting late at this point, because Sue's family was talking about going back to their hotels. So she's asleep, and I'm standing outside her room refereeing while her family figures out what they're going to do.
At this point, Sue's brother-in-law is starting to get cranky, probably because his routine has been disrupted. He's extremely rigid, bordering on pathologically so, and the only reason I can think of for why he even came is because Sue's sister, A, is both his wife and in some ways his caretaker. Which has hampered her efficiency somewhat throughout the whole ordeal, because [A] wants to be taking care of Sue, and he wanted [A] to be taking care of him.
So we're trying to figure out where people are going to go (we live about 45 minutes away), and brother-in-law keeps whining about how if they just left now, they'd be home by 11pm or something, as if that were the only thing under consideration. Finally, tired of all the back and forth, I make an executive decision: Her father and brother will get a room at a nearby hotel, and her sister and brother-in-law will go back to their original hotel room. This was as much to get him out of my sight as anything else. I agreed to text Sue's father once it was all over.
Sue was mercifully asleep for most of this. Unfortunately, it meant she was mostly asleep for what came next.
Sometime after giving her the phene.rgan, the next doctor (did I mention this took so long that we went into the next shift?) decided to switch her to cerv.adil, which started working quite well, quite quickly. This means she was woken up by the increasingly powerful contractions, which she felt completely on one side of her body [this I remember]because the fucking epidural never completely took. Everything started happening quickly after that. A blur of the doctor telling her when to push, and her saying she couldn't, [I remember this, too] while I said she could and holding her hand and stroking her forehead and telling her that I was there and wasn't going anywhere. I have no idea how long it took. There was nothing else in the world for me but her.
Sue doesn't remember much of this, and feels guilty for it - she seems to think that she was asleep for it, but I don't think it was so much that as being in enough pain and under enough stress that she didn't really form any memories of the experience. (There's a bunch of pedantic bullshit I could pull out about interruption of encoding and disruption of consolidation, but I won't. She had bigger things to deal with than remembering the moment.) [I talked to Dr. Shrink about this, and he said that under extreme stress the body takes care of itself by dissociating from what's going on.] Once the boys were delivered, Sue fell asleep, mostly from exhaustion. Once it was all over and I realized Sue was asleep, I messaged her father, leaned back in the recliner and closed my eyes, totally exhausted.
The next thing I remember was Sue screaming.
See, she still had to deliver the placentas. [Apparently,] this is much more difficult in a preterm delivery. They're more firmly attached. I opened my eyes to something like a nightmare. The doctor was giving orders to the nurses with some urgency, the room was dark except for an examination lamp, stark, sharp shadows everywhere. [I remember this like you remember a nightmare, clearly.] I could see blood on the doctors' arms up to the elbows. Sue was half out of her mind with pain, and kept asking for Tylen.ol. The doctor asked if she was sure that was all she wanted, and she said just give me something for the pain. The doctor told the nurse to push morphi.ne, then Sue screamed again, and the doctor increased the order of mo.rphine. [I remember all this, too. All of it. Clearly. She asked for 3 mg, then 5. I don't know why I asked for the Tyle.nol first.]
The doctor kept saying that she knew this was hard and painful, but they didn't want her to have to go to the OR for a D&C (which she had to get later anyway, when it turned out some tissue remained and went all necrotic). [I don't know why a D&C would have been worse at this point. How could it have been worse?] Blood, and my wife screaming. The whole time, I couldn't move. That's what I feel guilty about. My wife in agony, and I was so exhausted and shocked that all I could do was sit there, like a nightmare in which I am helpless to do anything. [All I remember is the pain, and the warnings about the D&C. C has nothing to feel guilty about.]
At some point, it was over. There was a lot of blood (enough that later she would need a transfusion before she could leave the hospital). Finally, Sue fell asleep, the morphine doing the work of Morpheus. I've never been so happy before or since to listen to her snoring.
[I recall a sponge bath and a change of sheets of the bed I was on once it was over and before I was transferred out of L&D. Somewhere in my head I realized I hadn't the strength even to feel modest. I just let her move me where she needed me, without a word of protest.]
Sometime around 6am, they moved us to the antenatal wing, into a cushy room. The nurse had already made up the couch bed for me, saying to us "when I saw it was you (she'd been a nurse when we were in for the initial consults after Christmas), I knew your husband would be right by your side." And I was. I waited until Sue was settled in, changed into something resembling sleepwear, and closed my eyes again. This time I slept until noon the next day. [He even slept through my family arriving, lunch arriving.] Time ceased to have any meaning, all ideas of normality were burned away. I wasn't even sad. I was just tired. I just wanted to sleep, knowing that I'd be waking up entirely too soon.
[I didn't have the heart to wake him. I remember moving around a bit, talking to the nurses as they took my vitals, helped me to the bathroom. Every once in a while a flash of joy over the birth of my boys, and then remembering. It happened a few times, and then I was so grateful for the distraction of my family's arrival.]
Brace yourself. It's long and difficult.
So we end up at a hospital where they can actually, you know, do what they're supposed to. Not the fault of our local hospital, unsuited as they are for anything but healthy pregnancies and the sort of injuries one obtains as a function of being a college student. Everyone there expressed their frustration with the ridiculousness of the State Attorney General's ruling that nurses couldn't push drugs for a preterm delivery. The ugly intersection of personal morality and public policy. The doctor was more reserved in his opinion, but I definitely got the sense that nobody was a fan of the policy. Small comfort*, yes, but if I'd had people all disapproving and shit up in my face, it would have been even worse than it already was. This is a new mantra in our household: It can always get worse. It can always be worse.
[*I think C is being generous here. It was all I could do not to completely lose it at the local hospital. You know, that quiet before the complete freak out.]
So we're in the University hospital, in an exam room because they were exceedingly busy and didn't have a labor & delivery room open yet. Also, the wing was in the middle of being remodeled. The first doctor we talked to talked to us about the paperwork required by the state: Apparently, along with the whole "nurses helping with preterm delivery are performing abortions" thing, there was a requirement that women attempting to deliver their children preterm had to be counseled about the availability of "alternatives" and had gone through a 24-hour waiting period. Because apparently, so many women drop by the hospital to abort their babies on their way to their mani-pedi appointments. To this hospitals' credit, we never saw that paperwork. The doctor to whom we spoke said, in essence, that it was bullshit and appalling that we'd ever be asked to do such a thing, and they'd already filled it out and filed it. [Thank god.]
I know, based on Sue's last post, that you all have a sense of the many of the things that went wrong or badly. Not everything did. With only a few (notable) exceptions, everyone was sensitive and compassionate, and even in some cases where things did not go well, I got the definite sense that the choices that got made were made in an effort to make it as quick and (relatively) painless as possible for us. But there we were, in an exam room, a transitional room, Sue hooked up to a contraction monitor, waiting. [Waiting: for our last ultrasound, for a real room away from the hubbub.] A fetal heart monitor was audible from next door - someone's healthy baby, heart beating away. A nurse was nice enough to turn it down for us [after only one request].
Another doctor came in to talk to us about the procedure, all smiles and bouncy...until she read the chart and saw why we were there. She outlined the approach they were going to take: Push a shitload of pito.cin fast [in increasing doses] to kick-start labor. Get it over with and done, both to keep from prolonging an awful thing and to help keep her out of the OR. Sounds good to me. We'd already been left hanging once.
Sometime after this (my internal clock went completely to shit once we were admitted - windowless rooms, days of shock and uncertainty. Hospitals are a lot like casinos: You have no idea what time it is, your money vanishes faster than you ever thought it would, and you may very well walk out with nothing to show for it.), we were moved to a labor & delivery room. A small, cramped, old labor & delivery room. One of the un-remodeled rooms. They kept saying they'd get us to a better room as soon as they could, but it wasn't to be.
They were getting slammed, from the sounds of it. Mostly because we were surrounded by the sounds of women delivering, celebrating deliveries, fetal heart monitors, and happy families. At one point, I walked out into the hallway to use the restroom (we shared one with an adjoining room, and the other people kept forgetting to unlock our door when they were done in there) and my head was filled with the heartbeats of other people's children. They followed me down the hall and crowded everything else out of my head.
Sometimes, I think I can still hear them. I still get uncomfortable listening to ultrasounds or heart monitors on television. [I get just a twinge.]
More waiting. More waiting. MORE waiting. Apparently, the pharmacy saw the amount of pito.cin the doctor had requested and said "this can't be right", but didn't bother to follow up. Doctor was not happy about this. Sue's already talked about the epidural, so I don't have much to add, other than the only thing that even partially redeemed the procedure was Nurse Bob. The nurses were, almost to a one, amazing, but Nurse Bob deserves special commendation. His compassion and sensitivity and gentleness were immeasurable. He was one of the things that kept it from being worse. [He held me as I got the botched epidural; one small comfort.]
We were there a long time. I don't know how long. The pitoc.in had [sort of] started to work and then plateaued. Eventually, someone figured out that the line wasn't sealed right or something and she wasn't getting the dosage she should have been for awhile. A big puddle of pitoc.in all over the floor. Her family came and went in different combinations. I don't remember much of this anymore. I was mostly focused on Sue anyway. I remember they kept asking me if I wanted them to spot me while I took a walk or something. I couldn't imagine being anywhere else other than Sue's side.
They kept fiddling with the amount of anesthetic she was getting in the epidural because it wasn't spreading to one side well enough. [They also tried rolling me to one side, hoping gravity would help distribute the meds. It didn't.] Lots of sitting, waiting, talking to people, waiting for the drugs to kick in. This was not going to be quick. Finally, at some point, Sue was getting nauseous, from what I don't really remember. [I think it was the empty stomach. I hadn't eaten all day.] She'd been hyperemetic throughout the pregnancy anyway. She was given some phener.gan to help the nausea. It also pretty much knocked her out, as phene.rgan is wont to do. [I remember family members coming in and out at various times,but I think it may have been later than this, after the boys were delivered.] It must have been getting late at this point, because Sue's family was talking about going back to their hotels. So she's asleep, and I'm standing outside her room refereeing while her family figures out what they're going to do.
At this point, Sue's brother-in-law is starting to get cranky, probably because his routine has been disrupted. He's extremely rigid, bordering on pathologically so, and the only reason I can think of for why he even came is because Sue's sister, A, is both his wife and in some ways his caretaker. Which has hampered her efficiency somewhat throughout the whole ordeal, because [A] wants to be taking care of Sue, and he wanted [A] to be taking care of him.
So we're trying to figure out where people are going to go (we live about 45 minutes away), and brother-in-law keeps whining about how if they just left now, they'd be home by 11pm or something, as if that were the only thing under consideration. Finally, tired of all the back and forth, I make an executive decision: Her father and brother will get a room at a nearby hotel, and her sister and brother-in-law will go back to their original hotel room. This was as much to get him out of my sight as anything else. I agreed to text Sue's father once it was all over.
Sue was mercifully asleep for most of this. Unfortunately, it meant she was mostly asleep for what came next.
Sometime after giving her the phene.rgan, the next doctor (did I mention this took so long that we went into the next shift?) decided to switch her to cerv.adil, which started working quite well, quite quickly. This means she was woken up by the increasingly powerful contractions, which she felt completely on one side of her body [this I remember]because the fucking epidural never completely took. Everything started happening quickly after that. A blur of the doctor telling her when to push, and her saying she couldn't, [I remember this, too] while I said she could and holding her hand and stroking her forehead and telling her that I was there and wasn't going anywhere. I have no idea how long it took. There was nothing else in the world for me but her.
Sue doesn't remember much of this, and feels guilty for it - she seems to think that she was asleep for it, but I don't think it was so much that as being in enough pain and under enough stress that she didn't really form any memories of the experience. (There's a bunch of pedantic bullshit I could pull out about interruption of encoding and disruption of consolidation, but I won't. She had bigger things to deal with than remembering the moment.) [I talked to Dr. Shrink about this, and he said that under extreme stress the body takes care of itself by dissociating from what's going on.] Once the boys were delivered, Sue fell asleep, mostly from exhaustion. Once it was all over and I realized Sue was asleep, I messaged her father, leaned back in the recliner and closed my eyes, totally exhausted.
The next thing I remember was Sue screaming.
See, she still had to deliver the placentas. [Apparently,] this is much more difficult in a preterm delivery. They're more firmly attached. I opened my eyes to something like a nightmare. The doctor was giving orders to the nurses with some urgency, the room was dark except for an examination lamp, stark, sharp shadows everywhere. [I remember this like you remember a nightmare, clearly.] I could see blood on the doctors' arms up to the elbows. Sue was half out of her mind with pain, and kept asking for Tylen.ol. The doctor asked if she was sure that was all she wanted, and she said just give me something for the pain. The doctor told the nurse to push morphi.ne, then Sue screamed again, and the doctor increased the order of mo.rphine. [I remember all this, too. All of it. Clearly. She asked for 3 mg, then 5. I don't know why I asked for the Tyle.nol first.]
The doctor kept saying that she knew this was hard and painful, but they didn't want her to have to go to the OR for a D&C (which she had to get later anyway, when it turned out some tissue remained and went all necrotic). [I don't know why a D&C would have been worse at this point. How could it have been worse?] Blood, and my wife screaming. The whole time, I couldn't move. That's what I feel guilty about. My wife in agony, and I was so exhausted and shocked that all I could do was sit there, like a nightmare in which I am helpless to do anything. [All I remember is the pain, and the warnings about the D&C. C has nothing to feel guilty about.]
At some point, it was over. There was a lot of blood (enough that later she would need a transfusion before she could leave the hospital). Finally, Sue fell asleep, the morphine doing the work of Morpheus. I've never been so happy before or since to listen to her snoring.
[I recall a sponge bath and a change of sheets of the bed I was on once it was over and before I was transferred out of L&D. Somewhere in my head I realized I hadn't the strength even to feel modest. I just let her move me where she needed me, without a word of protest.]
Sometime around 6am, they moved us to the antenatal wing, into a cushy room. The nurse had already made up the couch bed for me, saying to us "when I saw it was you (she'd been a nurse when we were in for the initial consults after Christmas), I knew your husband would be right by your side." And I was. I waited until Sue was settled in, changed into something resembling sleepwear, and closed my eyes again. This time I slept until noon the next day. [He even slept through my family arriving, lunch arriving.] Time ceased to have any meaning, all ideas of normality were burned away. I wasn't even sad. I was just tired. I just wanted to sleep, knowing that I'd be waking up entirely too soon.
[I didn't have the heart to wake him. I remember moving around a bit, talking to the nurses as they took my vitals, helped me to the bathroom. Every once in a while a flash of joy over the birth of my boys, and then remembering. It happened a few times, and then I was so grateful for the distraction of my family's arrival.]
Saturday, January 3, 2009
I thought I could do it
I just opened up my computer after spending $100 at the grocery store on mostly crap. Cookies, comfort food.
And yarzheit candles. I bought 4 of them. I'm not sure why I got 4. It's getting close to sunset; we'll light them soon.
I thought I could describe the 180 degree change in the demeanor of the OB resident when she realized what I was there for. And how she had to do yet another pelvic/cervical check (#12?) and ultrasound. The room was darkened for it; I couldn't look, finally, I just couldn't look at the ultrasound. C just held my hand and kept me looking at him.
I thought I could recount the different rooms I was in, all of which echoed with other women's healthy babies' heartbeats in neighboring rooms. How I heard and saw healthy woman laboring as I was wheeled in my bed down to my tiny laboring room.
I thought I could talk about the delay after day in getting the pit.ocin up to my room, so that (even though I was there at 6:30 am, I wasn't induced until about 2pm).
I thought I could describe how wonderfully easy it was to fall against the nurse, Nurse Bob, so I could get my epidural. And how the intern hit big nerves three times, enough for me to cry out, before his supervisor took over. And how the numbness never fully reached my right side. And how we were able make a lame joke, finally, about my having a lot of nerve.
I thought I could talk about how my family took turns sitting in my room because it was so small. There was nothing bigger available, as the department was under construction. Two at a time, plus C. My sister was a writer for sitcoms in a former life, thank god, so her innate sense of humor could make me laugh, even as I watched my stomach clench periodically. Her and the ativa.n.
I thought I could tell how awkward it was with my brother and BIL. And the low, florescent lighting cast a pall over everything. And how my father, through his smile to try to comfort me, looked so very sad and worried. How his big, rough hands held mine and patted them, gently.
I thought I could describe how inured I was to cervical checks, and how each one showed that I was not progressing and how it seemed my body didn't want to let go. How it wasn't until that evening that my protocol changed.
*****
There is much more from this day that I wanted to share. Perhaps I'll be able to tell more later.
And yarzheit candles. I bought 4 of them. I'm not sure why I got 4. It's getting close to sunset; we'll light them soon.
I thought I could describe the 180 degree change in the demeanor of the OB resident when she realized what I was there for. And how she had to do yet another pelvic/cervical check (#12?) and ultrasound. The room was darkened for it; I couldn't look, finally, I just couldn't look at the ultrasound. C just held my hand and kept me looking at him.
I thought I could recount the different rooms I was in, all of which echoed with other women's healthy babies' heartbeats in neighboring rooms. How I heard and saw healthy woman laboring as I was wheeled in my bed down to my tiny laboring room.
I thought I could talk about the delay after day in getting the pit.ocin up to my room, so that (even though I was there at 6:30 am, I wasn't induced until about 2pm).
I thought I could describe how wonderfully easy it was to fall against the nurse, Nurse Bob, so I could get my epidural. And how the intern hit big nerves three times, enough for me to cry out, before his supervisor took over. And how the numbness never fully reached my right side. And how we were able make a lame joke, finally, about my having a lot of nerve.
I thought I could talk about how my family took turns sitting in my room because it was so small. There was nothing bigger available, as the department was under construction. Two at a time, plus C. My sister was a writer for sitcoms in a former life, thank god, so her innate sense of humor could make me laugh, even as I watched my stomach clench periodically. Her and the ativa.n.
I thought I could tell how awkward it was with my brother and BIL. And the low, florescent lighting cast a pall over everything. And how my father, through his smile to try to comfort me, looked so very sad and worried. How his big, rough hands held mine and patted them, gently.
I thought I could describe how inured I was to cervical checks, and how each one showed that I was not progressing and how it seemed my body didn't want to let go. How it wasn't until that evening that my protocol changed.
*****
There is much more from this day that I wanted to share. Perhaps I'll be able to tell more later.
And so on
Not sure how much will get posted in the next few days, or what it will consist of. I can feel the tension and grief rising, and I don't know what, if anything will come through. More of the story, or ranting and crying.
Thank you for being here. It means a lot.
Thank you for being here. It means a lot.
Friday, January 2, 2009
Not so fast
Wednesday, January 2
We get up before dawn and get admitted to the hospital. I get my wristband and my johnnie by 7 or 7:30 am. Sara comes in and greets us. She tells us that she has asked to be my nurse for the day. I'm glad to see her, and it's good to know that she's there. As they're doing some initial bloodwork (for my clotting disorder) I ask for some ativan (I wanted to be aware, but really wanted something to take the edge off) and someone tells us what the basic protocol will be for the day. They use a dopp.ler to listen to my belly for any heartbeat. It's there.
My dad and brother are there with us, and my sister and BIL have an errand to run so they're coming later.
At maybe 8:30 or so the head nurse comes in and confirms what we'll be doing, and says that she has to check on something.
The nurses check on me, allow me ice chips, I make some uncomfortable small talk with my family. We wait. We are informed that she's trying to reach Dr. OB.
And wait.
So, what's going on, we ask, and the nurses say that there may be a problem with delivering here with me at only about 21 weeks, that the nurses may not be authorized to administer the medicine I need.
There are lots of raised eyebrows and requests to see the head nurse again. She comes in and says that they will not be able to induce my labor at this hospital. Because the pi.tocin requires frequent monitoring, and because of what it does, and because my baby still has a heartbeat, and because i am not already in labor, I need to be monitored by an actual doctor. A nurse is not appropriate, because it's too close to practicing medicine. (And, I think you know what else the state I live in thinks it's too close to.)
The town I live in is small. When the students are gone, there are only about 6 or 8 thousand people in the township (not just the town, but the township). There are only 4 or 5 OB/GYNs and only one on-call at a time. Because my baby has a heartbeat and I am not in labor already, only a doctor can tend to me. Apparently, this is a new law doctors' vs. nurses' responsibilities) and nobody in the medical field likes it, but this is state law and they can't do anything about it.
So, when my doctor had that far away look in his eyes the day before, I assume he was trying to figure out if this was going to work. I assume he was wrong.
It's kind of a joke in my family that when my father gets angry, his voluminous eyebrows climb his forehead. He's in his 70's, but he's got that look of authority that comes from working as an assis.tant att.orney gen.eral for a state in the northeast for 30 years. Now, I am my father's little girl. He asks the the head nurse for documentation and a contact at the state level. His eyebrows were almost off his forehead completely.
My doctor comes in and apologizes (or something) and says that he has a colleague at the big university hospital, and he will arrange for me to deliver there, since with all the resident M.D.s there won't be a problem with the law. He will do his best to get me in there tomorrow, hopefully.
Tomorrow.
By this time, my sister and BIL have arrived, the ativ.an is in full effect, which is the only way I can fathom that I got through this without completely freaking out. The nurse comes back with paperwork for my dad, Sara gives me a hug, and everyone but C goes so I can put my clothes back on without falling over. It's probably 9:30 or 10 am and we all head home. I sit on the couch all day.
At some point in the late afternoon, I get a call from Dr. Colleague, and he says he is arranging for me to come in the next day. "Did you fill out the form saying I am aware that at 21 weeks my baby will not survive delivery?" Um, no... "Well, there's this form from the state that requires you have to wait 24 hours before pursuing such a delivery. Unless there is risk to the mother's health. Don't worry, we'll complete it so you don't have to worry about that."
We talk for a few minutes about eating and heparin and, I think, some basic talk about what will happen the next day. We need to be there at 6:30 am, when they'll do intake and get me a room. Being such a big hospital, with a level 3 or 4 nicu, they see a lot of people in similar situations. They will do their best to set me up away from the other mothers.
I would get my leaf though.
If I could only get through another night.
We get up before dawn and get admitted to the hospital. I get my wristband and my johnnie by 7 or 7:30 am. Sara comes in and greets us. She tells us that she has asked to be my nurse for the day. I'm glad to see her, and it's good to know that she's there. As they're doing some initial bloodwork (for my clotting disorder) I ask for some ativan (I wanted to be aware, but really wanted something to take the edge off) and someone tells us what the basic protocol will be for the day. They use a dopp.ler to listen to my belly for any heartbeat. It's there.
My dad and brother are there with us, and my sister and BIL have an errand to run so they're coming later.
At maybe 8:30 or so the head nurse comes in and confirms what we'll be doing, and says that she has to check on something.
The nurses check on me, allow me ice chips, I make some uncomfortable small talk with my family. We wait. We are informed that she's trying to reach Dr. OB.
And wait.
So, what's going on, we ask, and the nurses say that there may be a problem with delivering here with me at only about 21 weeks, that the nurses may not be authorized to administer the medicine I need.
There are lots of raised eyebrows and requests to see the head nurse again. She comes in and says that they will not be able to induce my labor at this hospital. Because the pi.tocin requires frequent monitoring, and because of what it does, and because my baby still has a heartbeat, and because i am not already in labor, I need to be monitored by an actual doctor. A nurse is not appropriate, because it's too close to practicing medicine. (And, I think you know what else the state I live in thinks it's too close to.)
The town I live in is small. When the students are gone, there are only about 6 or 8 thousand people in the township (not just the town, but the township). There are only 4 or 5 OB/GYNs and only one on-call at a time. Because my baby has a heartbeat and I am not in labor already, only a doctor can tend to me. Apparently, this is a new law doctors' vs. nurses' responsibilities) and nobody in the medical field likes it, but this is state law and they can't do anything about it.
So, when my doctor had that far away look in his eyes the day before, I assume he was trying to figure out if this was going to work. I assume he was wrong.
It's kind of a joke in my family that when my father gets angry, his voluminous eyebrows climb his forehead. He's in his 70's, but he's got that look of authority that comes from working as an assis.tant att.orney gen.eral for a state in the northeast for 30 years. Now, I am my father's little girl. He asks the the head nurse for documentation and a contact at the state level. His eyebrows were almost off his forehead completely.
My doctor comes in and apologizes (or something) and says that he has a colleague at the big university hospital, and he will arrange for me to deliver there, since with all the resident M.D.s there won't be a problem with the law. He will do his best to get me in there tomorrow, hopefully.
Tomorrow.
By this time, my sister and BIL have arrived, the ativ.an is in full effect, which is the only way I can fathom that I got through this without completely freaking out. The nurse comes back with paperwork for my dad, Sara gives me a hug, and everyone but C goes so I can put my clothes back on without falling over. It's probably 9:30 or 10 am and we all head home. I sit on the couch all day.
At some point in the late afternoon, I get a call from Dr. Colleague, and he says he is arranging for me to come in the next day. "Did you fill out the form saying I am aware that at 21 weeks my baby will not survive delivery?" Um, no... "Well, there's this form from the state that requires you have to wait 24 hours before pursuing such a delivery. Unless there is risk to the mother's health. Don't worry, we'll complete it so you don't have to worry about that."
We talk for a few minutes about eating and heparin and, I think, some basic talk about what will happen the next day. We need to be there at 6:30 am, when they'll do intake and get me a room. Being such a big hospital, with a level 3 or 4 nicu, they see a lot of people in similar situations. They will do their best to set me up away from the other mothers.
I would get my leaf though.
If I could only get through another night.
Thursday, January 1, 2009
New Year's Day
It was a Tuesday.
I had some questions for my OB, but couldn't bring myself to make the call. C called the off hours number, and shock of shocks, my regular OB was on call, back from vacation. He had gotten a few of the faxes, but was not up on the whole saga. C asked some of my questions and tried to answer some of his. Dr. OB suggested meeting in the office so he could examine me and see what was going on. He would open up the office at 2 and we would meet there.
We told him what happened, what some of the doctors had said, and that we were anticipating an induction, unless of course, he found huge pockets of fluid and thought things looked less dire than the others. He noted some light bleeding and asked if anyone had said anything about placenta previa (they hadn't, and I don't think there was any) and pulled out the ultrasound machine. I couldn't help but look.
This is the doctor who, when the NT results came back said "this is why I hate this test. when I asked him why he hadn't said anything, he said it seemed that I had already made up my mind."
There was not more fluid. Joshua was in horrible shape. Dr. OB thought the prognosis for Jacob, for even making it to 24 weeks, was very poor. I remember I said, "so, basically we're just waiting for one of us to develop an infection." Somberly, he nodded, "yeah," he said.
He confirmed that we had all but decided on "active management," he looked grave, quietly nodded, and said, "Yeah, I think we can get you set up for tomorrow. Come in at 6am." We asked questions, like, how long would it take (16 hours?) I don't remember what else. "Yeah, we should be okay for tomorrow," he said.
We went home and I guess I sat on the chaise end of the couch. My brother and sister cleaned, my father made phone calls. I don't know. I think everyone left early, going back to their motel, since we'd be up at the crack of dawn, and so C and I could be alone. My family would meet us at the hospital.
I took a shower kind of late, and C stayed in the bathroom with me while I bathed since I was feeling unstable physically and emotionally. Our last night with the boys. It was unreal.
I had some questions for my OB, but couldn't bring myself to make the call. C called the off hours number, and shock of shocks, my regular OB was on call, back from vacation. He had gotten a few of the faxes, but was not up on the whole saga. C asked some of my questions and tried to answer some of his. Dr. OB suggested meeting in the office so he could examine me and see what was going on. He would open up the office at 2 and we would meet there.
We told him what happened, what some of the doctors had said, and that we were anticipating an induction, unless of course, he found huge pockets of fluid and thought things looked less dire than the others. He noted some light bleeding and asked if anyone had said anything about placenta previa (they hadn't, and I don't think there was any) and pulled out the ultrasound machine. I couldn't help but look.
This is the doctor who, when the NT results came back said "this is why I hate this test. when I asked him why he hadn't said anything, he said it seemed that I had already made up my mind."
There was not more fluid. Joshua was in horrible shape. Dr. OB thought the prognosis for Jacob, for even making it to 24 weeks, was very poor. I remember I said, "so, basically we're just waiting for one of us to develop an infection." Somberly, he nodded, "yeah," he said.
He confirmed that we had all but decided on "active management," he looked grave, quietly nodded, and said, "Yeah, I think we can get you set up for tomorrow. Come in at 6am." We asked questions, like, how long would it take (16 hours?) I don't remember what else. "Yeah, we should be okay for tomorrow," he said.
We went home and I guess I sat on the chaise end of the couch. My brother and sister cleaned, my father made phone calls. I don't know. I think everyone left early, going back to their motel, since we'd be up at the crack of dawn, and so C and I could be alone. My family would meet us at the hospital.
I took a shower kind of late, and C stayed in the bathroom with me while I bathed since I was feeling unstable physically and emotionally. Our last night with the boys. It was unreal.
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