Test, test

Hello there! I am writing from the present because I thought of this blog today and then I thought about how I always hated it when blogs just ended before you could know how things worked out for the writer.

It has been almost six years since I last wrote. Since then, our son has grown into a beautiful 9-year-old boy. He remains our only child. We had no success with IVF. We moved on to donor eggs, but that process was seemingly cursed from day 1. Every step of the way, whatever could go wrong went wrong. Test results were misinterpreted, the first donor we set our hearts on suddenly became pregnant, phone calls weren't returned, and then the next donor we chose threatened to quit because our hospital was moving so slowly and making so many errors (despite being named one of the top RE centers in the country). And finally, when we had persuaded the donor to stick with us and everyone had done all the required tests and the donor was one week away from beginning stims, we got a last-minute test result back...a screen that no other clinic had done in her (multiple) previous cycles. And that test showed she was a carrier for a really terrible fatal disease where children die before their third birthday. And at that point, we were done. We had already been ambivalent about the whole experience, but that nailed it.

We moved on to private infant adoption. The home study process was fairly painless, but when we began to be presented with possible matches, the number of red flags we were seeing with the cases and the pressure to make instantaneous decisions was overwhelming for...well, it was more overwhelming for my husband than it was for me, but no one was feeling good about it. Here's one actual example, though I've changed some details to be safe...

"Hi Anna. So we have a possible match. Mom is 35 weeks pregnant but says she just found out about it. She has three other children but doesn't have custody of any of them. Her drug screen did come back positive for amphetamines, but she says she took cold medicine, so that could explain it. Anyway, we need your answer by 5, byeeee!"

So we walked away from that, too.  But today we got word that, after a lengthy, oh so lengthy process of training and form-filing and home studying, we have finally been approved to adopt from foster care. There is a long story to how we came to choose this path, but that would require betraying the privacy of a little boy who has become our godson. He has a parent to care for him, but we provide backup. Knowing him opened our hearts to the possibility of another child who might not have a family member to take care of him. And the process has really been fairly painless. Slow, sometimes scary to contemplate, but also doable.

Given the nature of foster adoption and the need to protect privacy, I'm not sure how much I'll post here. We may not even find the right match. But if there is a worthwhile update to share, I'll figure out a vague-enough way to share it.

Next Steps

We're doing our treatment at the same large university hospital where I was treated during my pregnancies with Sam and Eva. It has a reputation for being both innovative and impersonal, and I've definitely been painfully aware of their "take a number and move to the left" approach to managing IVF patients. At the same time, I understand that the reason the RE practice operates this way is so that the maximum number of patients can make their way through the system. If I was getting all the hand-holding and open-ended appointments I'd like, someone else might not be able to get an appointment. So I'm making peace with it, while also making an appointment for a consult at a smaller clinic.

To his credit, though, my regular RE did call me twice last week, once as a purely "social call," as he put it, because he knew we were disappointed, and then again to tell me that the team had reviewed my cycle and decided that it would make sense to give me another shot at IVF with my own eggs using a slightly different protocol. I'll have more details about that next week when we meet with him in person, but I appreciate that a) he took the time and b) they haven't given up on me yet. He also said that we should discuss "other options," including donor gametes, which I expected.

Meanwhile, I've started taking 2.5 mg of Melatonin, 75 mg of DHEA, and a prenatal vitamin each night and 400 mg of Coenzyme Q10 and some fish oil each morning.I'm also embarking on a calorie restricted diet. Because when this is all over, I need to be able to tell myself that I did everything I could.

I'm a little concerned about the Melatonin because I hear it can have a dampening effect on your mood if you're at all prone to depression. But I'll try it for a few weeks to see what happens.

One thing that certainly didn't help the mood: We did a consult yesterday with another doc (I am being nothing if not thorough). This guy didn't come particularly recommended, but he is affiliated with my health plan so I didn't have to get a referral to see him. And I'm not sure if he was trying to discourage me so as to not blow his stats with another 41-year-old marginal responder on his rolls, but he couldn't have been less optimistic for us. "You were on the maximum dose of stims," he said, "And I would've done the same protocol with you, but if you want to do another cycle, we can do that, just so you can say you tried your best." I wanted to talk to other docs to see if they would suggest different stims or a different protocol, but this guy had nothing to offer. And I cried a lot last night, feeling like it's time to grieve the end of my fertility.

But maybe it's not time quite yet. I'm going to make a deal with myself: I may well end up having to grieve for that, but not until later this fall when I have more info. And I'll try to be hopeful until then.

Meanwhile, we'll have to decide if we should try to cycle in September or in October, when the supplements, accupuncture, and diet will have had more time to take effect.

Over

Both Sam and Eva were Kell-positive. We know this. Ironically, the two embryos we got from this cycle were Kell-negative. But they both were chromosomally abnormal, so there was no transfer today.

We had a moment of feeling hopeful...they looked great on Friday when I called for an update. 7 and 8 cells each respectively. High quality. But the PGD report came back this morning and it is as my doctor probably assumed it would be. Old eggs, bad chromosomes. I feel so defeated and pathetic. I'm grieving for the fertility that may well be gone now. And I can't quite believe that it's over. But how can we win this numbers game if I can't produce enough embryos? We can't. To start with six and try to produce one embryo that's both sound and Kell-negative? I'm guessing that when we meet with the RE sometime in the next couple of weeks, we'll be having the donor eggs talk. And I just want to lie in bed and cry.

And then there were...

Two. Turns out I got it wrong: 2 of the eggs were immature. Only 4 were mature. One was fertilized by 2 sperm. And one disintegrated. So now we have two.

I'm not destroyed by this news, but a mild depression has settled in. I'm probably having a better day than Kristin Stewart, so that's something.  I am  happy that only 1 of them actually old-lady-disintegrated. But I also know that this is just day 1, and the chances of ending up with a healthy Kell-negative embryo by Sunday are pretty damn slim. My RE was the one who called, not his nurse, a sure sign of bad news, and he said that it was an option for us to freeze the two embryos and save them for the next cycle. But what's the point? Freezing destroys embryos much more than biopsy. So if we have 2 to biopsy by Friday, we'll do it.

Six

Six follicles, six mature eggs. Just like Seven Brides for Seven Brothers. Of course, I was half-hoping that a couple of the larger follicles would have 2 eggs each, but I'll take it. Now I'm just going to pray that at least half of them make it to biopsy.

The procedure itself wasn't a walk in the park, but it wasn't terrible. On the scale of difficulty/inconvenience, with 1 being easy and 10 being agonizing, I'd say that the shots were 1 and the egg retrieval was a 6. The pain wasn't terrible, but I do feel quite tender. And I'm just not a huge fan of the whole "procedure" thing, the arms out like Jesus, the cold room, the people in masks, being put under, the needle up my vagina. For the few procedures/surgeries I've had, I always cry beforehand. And of course, this is the first real procedure I've had done at this hospital since I delivered Eva, so that kicked up some feelings.

And since there always has to be one asshole at every big hospital occasion, the anesthesiolgist kindly played the part. Don't they always? As he gave notes to the nurse in front of me, he said, "well we had another dose of Fentanyl ready, but there weren't many eggs, so we didn't need it." Thanks, dude.

In summary: ER not too bad, but not something I want to do more than a few times. On the other hand, if it brings us a baby at the end? Worth it.

Triggered

So Adam just gave me the hCG shot, which didn't hurt at all, despite the scary needle. And so that's that. How we did joke, btw. His one chance to poke me to get me pregnant, hah-hah.

Final tally: 6 mostly mature follicles, one additional follie that may or may not mature by Tuesday, my retrieval day. Sizes: 23x14, 17x14, 19x12, 23x19, 19x14, and 16x6. The other one is at around 12.

This isn't great for a PGD cycle. But right now I'm just grateful to have made it this far. At least I didn't get cancelled, right? If we don't end up with enough embryos to biopsy, we can at least try and freeze the ones we have and try again. I guess the worst case scenario would be if none of the eggs fertilized. That would really suck. My intuition is that if we do get one decent Kell- embryo to transfer, I have a decent shot. But that isn't so very likely.

There is one man who works at the hospital's ultrasound lab on weekends. He is so unbelievably kind, and at 7:30 in the morning. He has the manner of a good priest or rabbi. Women are so often beat up by this  infertility grind. We endure so many moments of despair, of feeling kicked in the stomach by some friend's pregnancy announcement or some party where all the conversation is all about kids or should I have a third? And this man treats you like he sees the bruises on your soul. It means so much.

Day 12

Five whole follicles today, with a few more in the works. I don't know if they'll get big enough to mature by the time the other follies are ready to go, but I went for more acupuncture today to try and help nudge them along. Estradiol is just south of 800. So I guess I'm just happy that this isn't a complete and total bust. I can live with "not stellar," "not great," as long as I still have a chance. In an ideal world, I would prefer to not earn the "poor responder" label if at all possible, but that's out of my hands.

Of course, I have no idea how viable any of these eggs are, but the ultrasound tech (herself an IVF grad and so very understanding) said that sometimes a slow stim can lead to better fertilization. Who knows if that's true. This is all so new to me.

Oh, and my lining is great. I guess it's at 8mm so far with 3 distinct layers. So I excelled in one area. Yay!

God, can there be anything more navel-gazing than doing IVF? I'm literally staring at my navel all the time, silently wishing for everything under it to kick into gear. And then I come here to report what's going on in there.

Hope Springs, Day 10

So after yesterday's acupuncture session, I felt a bit restored. My doc was so kind and upbeat, and she gave me such confidence in my awesome kidney pulse fluttering away so fertilely. I began to think that maybe all hope wasn't lost...

And then a little later I felt hopeless again and cried. I got a bit of work done and sent it to my boss. I focused on snuggling Sam and feeling that mama love all over my body. I made dinner, watered the garden, did my shots. I took my supplements and listened to a fertility meditation on my headphones in bed. And while I was visualizing my secret fertile garden and the child who visits me there (Sam, plus a faceless glowbaby), I imagined my abdomen (can't bear to type "womb," blegh) as a place of life and not death. I imagined the black dust of death that has settled in there and pictured blowing it away and starting fresh. And I prayed for one more chance, please. Just one more good egg.

At today's scan there were 3 larger follicles as before, but a bunch of new ones on both ovaries are starting to take shape. I should've asked for an exact number---Damn those rushed nurse calls---but it sounded like several on each side. My estradiol is only up to 400, but that's double what it was 2 days ago. Maybe my ovaries will be capable of meeting all this aggressive stimulation with more than a cough and a wheeze. At least there's still some hope. It's not over yet. Next ultrasound on Friday.

Pray

I'm on day 9 of stims and off to a very slow start. Estradiol is rising slowly and I only have 3 follicles as of yesterday morning. I'm doing all I can...adding acupuncture, CoQ10, melatonin, and fish oil to the routine to give my body any advantage I can. But if you happen to be reading this and could send some prayers my way, I'd be grateful. I don't know exactly what I believe about God or a universal order anymore, but I'm praying anyway. Praying for just one more little life for us to bring forth and cherish.

One possible bright spot: the nurse says that even if this cycle doesn't improve, they can freeze any embryos that we do get and then do another cycle to try and produce enough for biopsy and PGD. So at least this cycle doesn't have to be a total waste.

Why I Call It a Stillbirth

I realize that technically Eva's death, at 19 weeks, was still considered a miscarriage, but my feeling is that when you birth your child and then hold her, kiss her head, look at her perfect little hands and feet, and have to decide when to hand her body over to the nurse knowing that you'll never see or touch her again, that's more than "just" a miscarriage. And having had two of those, I'm not making light of that loss, either.

Hail Mary Pass

I injected my first dose of Lupron tonight. I'm scared. It has been 21 months since E died and we have achieved some degree of normalcy and happiness and now we're wading back into the water for one last Hail Mary Pass at having a baby through IVF with PGD. It's our best shot at having a biological child without losing him or her to Kell again. So after months of recovering from our loss and then more months of waiting for the genetic testing to be done and all the minor tests of my uterus and blood, I injected the Lupron.

There is a lot in this process that could unsettle me. The potential mood swings from the drugs themselves. And then the potential trauma of an IVF cycle that fails, or succeeds but ends in miscarriage, or succeeds and results in a high-risk pregnancy in some other way. Even a healthy perfect pregnancy will certainly rake up a lot of sense memories of my last pregnancy. And that is an unlikely outcome anyway. I'm so old now, relative to the fertility world. I'm 41. My FSH numbers aren't great. It has been 6 years of trying to build a family with 2 kids in it and here we are.

So why not just stop now and be grateful for Sam? Oh my God, I am grateful. Every day I am so grateful for him. I could settle into being a happy family of 3 and move on. Why not?

But I'm just not done. I just snuggled Sam to sleep and that Mama bliss is what makes me soldier through this. I want more of it. I want more of the physical experience of pregnancy and nursing, if I can have it. Maybe I can't. But we have this chance and I need to give it at least one try. And if we try and still can't have it, we'll look at our options. But it would be nice to not have to work through that loss. And that's also the most likely thing. But if there's a chance, we have to try.

So here is this bag of drugs sitting next to me on the bed, as daunting as anything I've ever owned. I am so lucky to have access to these drugs, so lucky, and they scare the crap out of me. But we move forward. Second Lupron injection tomorrow morning, followed by the baseline ultrasound.

Still here

The spring was really hard. After mostly avoiding the emotional burden of jealousy and bitterness until then---a bit of grace I was really grateful for at the time---the ugly twins finally caught up with me. Some friends had babies, others became pregnant. It was a kick in the stomach every time. More like a knee in the gut. And it was double the burden for the way it then made me feel guilty for being bitter, the way it isolated me from people I genuinely care about, and how obvious it was to me that they pitied me on some level, or at least felt awkward around me in light of their good fortune, and how that made me hate them. There is simply no winning in these situations.

The summer got better. My beloved cat died, which was horrible. But the grief for Eva let up a little. Once we had time to recover from losing the cat, the first "baby" that we ever had, we were wrapped up in moving from one house to a temporary apartment and then another house that we've been renovating. We were a little band of travelers together, sharing a bedroom for a few weeks, and the closeness was soothing. As the deep grief and bitterness lifted, I began to have glimpses of how you come to accept something as awful as birthing and holding your dead daughter. You don't condone it, you don't want it, you'll never totally accept it, but you stop feeling like you can't really live the life you're in. You stop feeling that you're in the wrong life. You realize that this is the life you have and there are some good things about it. Things to embrace.

So that's where I've been spending more of my time. But I write now because we're coming up on the one year anniversary. One year ago today, I had a bad ultrasound that indicated that Eva was gravely anemic. That the bizarre Kell isoimmunization issue that we had discussed at every appointment might actually amount to something very serious and in need of immediate treatment in the form of a fetal transfusion. Over the next days, it just got worse. The treatment that would've worked if she had been just 3 weeks older before getting sick couldn't help. I keep thinking of that line from Elizabeth McCracken's An Exact Replica of a Figment of My Imagination. I don't have it here with me. She's talking about the day she felt something was wrong with her pregnancy---the baby wasn't moving. In her case, this was at full term. She describes the vague concern followed by the nagging worry, the consultation with the midwife, the reassurance. "And then," she says...and I forget what the next word was. Catastrophe? Calamity? But she gave words to the moment between the old life and the new life, the pause before you plunge into an abyss.

I see that this is how the story turned out for us. What a horrible fucking thing. What a fucking travesty that my daughter died.

I don't know what happens next. We were too wrecked all year to decide what the next move was. We're starting to talk now. I'm old now...40. How unfair that we had the two miscarriages...lost all those years between when we first started trying at 35 and now. And yet we have Sam. How lucky is that? And how lucky are all the other good things? And yet Eva is still dead and trying to be grateful can sometimes get me ping-ponging between peace and self-pity and shame and anger.

Update

Well, I left this blog on an ominous note and I feel inclined to note that I haven't fallen off the planet, at least.

What has happened since we lost Eva and today is mostly a lot of daily life. We didn't fall apart as much as circumstances might have allowed. In fact, in the early days, I was flooded with this very odd, very deep sense of gratitude for Sam in particular, but for all the other good things in my life. I feel that there's this trick that happens immediately after some losses. Maybe it's grace, maybe it's a neurological response, maybe it's both. But something cushions the blow in the beginning, if you're lucky. Even when you're on your knees sobbing and saying, "I can't do this," there is a moment soon afterward where you think, "We'll be okay." I think it's much harder after the initial crisis when you realize that the shitty thing is still there, only without everyone rallying around you. And the shitty thing shall remain evermore, get used to it.

I now understand what Joan Didion said about magical thinking. I've had so many moments, particularly when visiting the hospital where we were during the pregnancy, where I've had the half-conscious thought that maybe Eva didn't really die or that maybe this new doctor will be able to make things turn out differently. It's hard to even articulate because it's so nonsensical. It evaporates when brought up to the level of words.

Now the grief hits in occasional storms. Not waves, but storms. More storms lately because my due date is this week. When I'm in the storm, I absolutely can not see out of it. I feel desperate. Clawing, screaming, pounding desperate (I save it for when I'm in the car alone. Parked). In those moments, I feel that I am ruined, that Adam and I are ruined, that I must have another child right now because that is the only way I'll ever heal from this. Or, I'll feel that we can never take such a terrifying risk because surely that will destroy whatever good is left. And now we're even more ruined because I'll never stop longing for another child and never stop feeling jealous of every family with more than one and oh my God it is exhausting to be like this. God bless my parents who have gotten two such phone calls from me in recent months. Thank God they're still here to talk me down from the tree. I feel irrational rage toward Adam in these times and I'm glad I at least have the sense to shield him from it.

And when the storms pass, they're just gone. Most days I can feel quite happy. There is a shadow over things maybe. I can see it if I look for it. But most of the time it doesn't distract me.

If we want to have another child, if we want to take that risk, we have three options: use a sperm donor who is Kell negative, do IVF with PGD, or adopt. I suppose we could throw a non-Kell-sensitized surrogate into that mix, but it's not going to happen. I have no idea if we'll try any of them. Adam is so very wary (part of the reason for my rage during the storms). And when I'm not feeling desperate, I tend to agree with him. We got this one beautiful, perfect (within the range of human imperfection) child. We're lucky in many ways and happy on most days. Let's just be grateful for what we have and move on. Think of all the easy traveling we can do! A cozy family of three.

And yet...I think about my life ten, twenty years from now and will I be at peace with it then? Do I want Sam to live his life without a sibling? No answers yet.

And again

We have had two years of such happiness. Overall, I mean. There was a cancer scare last spring---a benign tumor on a fallopian tube that looked a little scary in the ultrasounds. And stuff. Just regular life stuff that was challenging. But we have had so much happiness. We have Sam. And last spring we decided that yes, we both wanted to try again because of the love, and for Sam to have a sibling, and wanting to experience the baby thing one more time. Mostly because of the love. And so we started trying to get pregnant in May and got pregnant in May and despite my old age it all happened so easily for us. And then our doctor told us that looking over my charts and all the latest research, he didn't even think I needed to take Lovenox this pregnancy. No more shots, just a little baby aspirin to be safe. For the first time in four years, my IgM antibody levels were down to normal range. And so here was the easy pregnancy, for once. I think it did feel like a reward.

And now that baby is gone at 19 weeks. Her name was Eva. You think that once you've been through the forest, you know the most fearsome creatures that dwell there, but there can be other monsters you didn't even imagine. For us, that was the Kell antibodies that we'd never heard of, mostly likely created when I gave birth to Sam and our blood mixed in some quantity. Sam had inherited his dad's genes, which were different from mine. He had a little protein on his blood cells that was different from the little protein on mine. And when my body sensed his foreign blood, it went on alert, producing antibodies to his type. He was safe, as he was already delivered. But Eva had Adam's genes, too. And my body had been primed to seek out her blood type. Search and destroy.

There wasn't a thing wrong with her, except that she was trying to grow in the wrong body.

By 18 weeks, when they began to look for signs of a problem, she was already so sick. A sick, tiny baby. They tried to save her, but she was too too small to save. It doesn't usually happen like this. Usually the baby doesn't get so sick so soon. Usually it happens later, if it happens at all. And then there are treatments—transfusions, namely—that work in the vast majority of cases. Ninety, ninety-five percent of these pregnancies end with a healthy baby at home. But at every turn of our story, the bad thing happened. What could've gone wrong went wrong.

I think this latest tragedy probably puts this blog into radioactive territory. After my second miscarriage, I went to a support group for the unfortunate minority grieving miscarriage, stillbirth, neonatal loss. The stories I heard there were terrifying. Instead of comfort, I found new outcomes to fear. I drove home panicked.

Maybe that's how our story reads now, too. But I know we don't even have it that bad. It can always be so much worse. We have Sam. What more does the universe owe us? We get to be parents. Every day, he pulls us back into life.

And yet Eva is gone. My baby. I delivered her still, tiny body three weeks ago. We held her. Our daughter is dead. How do we live with that sentence?

Revisiting the diagnosis

Two years ago, when I was living on the Left Coast and first got the news that I sort-of had antiphopholipid syndrome (I'll explain that in a sec), my reproductive endocrinologist told me that, while she didn't expect me to exhibit any symptoms of APS outside of my tendency to miscarry, I should have annual blood checks to make sure my antibody levels didn't go through the roof. Also, I should make make sure I wasn't developing any of the antibodies associated with lupus, which sometimes exists concurrently with APS (though the relationship isn't thought to be causal).

So that was two years ago, and last year I was busy having Sam (yay!) and didn't get checked. But I went back a few weeks ago to meet with a rheumatologist here in my East Coast city.

If there's one thing your doctor likes to tell you when you show up with an autoimmune disease, it's that "there's still so much that we don't know." Here's a summary of what I've learned so far:


1) To get a diagnosis of APS, you have to meet both clinical and laboratory criteria. Clinical criteria include venous or arterial thrombosis and/or pregnancy losses (specifically, one or more miscarriages after 10th week of gestation, three or more miscarriages before 10th week of gestation, or one or more premature births before 34th week of gestation due eclampsia). To meet lab criteria, you have to test positive for anticardiolipin or lupus anticoagulant antibodies on 2 occasions of some weeks apart (6 to 12 weeks, depending on which antibodies they're looking for).

2) My particular problem antibody is of the anticardiolipin sort -- specifically, IgM (Immunoglobulin M). IgM and IgG antibodies are measured in the following way: fewer than 12 units = normal; 12 to 20 units= borderline; 20 to 80 units=moderate; more than 80 units=severe. My understanding is that lupus anticoagulant antibodies are a binary thing: either you have them, or you don't.

3) APS (also called Hughes Syndrome) can be quite a serious disease in some people, but there's a current line of thinking that there may be a population of women whose only symptoms are pregnancy-related. That is, they don't appear to be in danger of pulmonary embolism or thrombosis outside of pregnancy.

I've now had my IgM antibodies measured four times. After the miscarriages, they came in at 21.2 and 21.6, measured 7 weeks apart. During my pregnancy with Sam, while I was taking Lovenox, they were at 16. At my most recent visit, they were 19. It looks like I have a "mild" case. I've "only" had 2 miscarriages. No clots.

So...my docs on the left coast felt that while I was a borderline case, they should still treat me as if I definitely had APS. And so I went on Lovenox as soon as I knew I was pregnant with Sam. And it worked.

But the rheumatolgist here, who doesn't specialize in APS or miscarriage, wasn't as convinced. "Your levels are so low," she said. "Who knows if those first two miscarriages were just a matter of bad luck? And it's not like there aren't risks to being on blood thinners. I'm not sure if I'd even want you to be on Lovenox if you get pregnant again."

But, of course, if I get pregnant again (something Adam and I are discussing only in vague terms, with no final answer), I'll get right back on my vitamin L. Maybe it was just a matter of luck that this pregnancy worked. Maybe my ovaries are shaped like little roulette wheels. But I'm pretty convinced the drugs saved Sam's life, and in the matter of reproductive endocrinologist v. rheumatologist, I'm going to listen to the people with the better track record of bringing healthy babies into the world.

And on

Still feeling strange an vulnerable. Obsessing about Jade Goody and Natasha Richardson, being overprotective of Sam. At some point, I'll be able to remember that most people live for decades and I don't need to be on alert. But not now.

Pulling me back into the present, Sam seems to have learned his first word: Duck. Rather, "guck." It is incredible. "Guck, guck, guck," he was saying as I stood at the bathroom mirror. I looked down and saw that he was talking to the little rubber duck on the edge of the bathrub. "Guck-guck-guck-guck." "Yes!" I said. "Guck," he said.

Anniversary Waltz

Adam left for a business trip this morning. It's a short one—he'll be back Tuesday. But in the days leading up to his departure, I've been feeling so anxious about it—enough that I was thinking about all those stories you hear when the wife says she has a bad feeling about a trip and then the husband stays home and the plane he was supposed to be on crashes.

But it wasn't just the flight. I was worried about being left solo to care for Sam, which didn't make sense because Adam travels at least once a month and I've found that I really enjoy the special one-on-one time.

And why were my thoughts turning to people dying, people who've died, and worst of all, children who died? Why was I perusing so many of those blogs this past week?

I was just downstairs mulling all of this grim business, wondering what was wrong with me, when I finally realized what it was. March 15. My due date for the first baby. Our first baby who would've been two today.

How quickly the conscious mind pretends to forget, and how the body always remembers.

We would've been thrown a second birthday party for you, little one. Everyone would've come and I would've made you a cake and we would've been so happy. I am so sad that you're not here. I'm so happy to have little Sam, but I'm so sad you're not here.

Catch and release

Sam is going through a Mommy phase. He just needs a lot of contact. He has this little game that I call "hug and look around," where he stands up, facing me, squeezes me tight, then pivots around to take in the world around him, then squeezes again. I love it. Love, love it. And it is such a pleasure to be needed like that and to be able to reassure him.

Only...his phase corresponds to the busiest month of work I've had in...years. Certainly in his short life. The volume of work is insane. And I just feel so miserable about all the time I'm spending away from him. Every day, I want to quit.

How can we be almost 40 years beyond the second wave of feminism and have so little to show for it?

My employers aren't cruel or unreasonable. They let me work from home one day a week. They do what they can to spare me the late nights that everyone else is putting in. I have no complaints about them, really. It's just that the nature of the job is incompatible with motherhood.

Blah, blah, blah. It's just a tough situation right now. I miss my baby. My body feels torn in half when I'm gone so much. We went through a lot to have him and I'm tired of feeling like I'm missing everything.

Meanwhile, I finally got around to making an appointment with a rheumatologist. Back when I was diagnosed with antiphopholipid syndrome, my doctor suggested I go in for annual blood draws to assess my anticardiolipin antibody levels. I'm a little overdue.

As far as antiphospholipid syndrome (APS) goes, I'm lucky, if you can set aside the two dead babies, which, of course, you can't. My antibody levels were reasonably low, even at their highest, and they were even lower when they last checked early in my pregnancy with Sam. Barely made it into the "disease" range. It appears to be something that only acts up during pregnancy for me, and Lovenox was my magic bullet on that front.

So I think I'm pretty healthy now. But there's always some concern once you've wandered into the world of autoimmune disease. Sometimes APS is a precurser to Lupus. That's scary. But my doc said I didn't fit the profile, so other than a few weeks when I felt particularly achy after Sam was born, I haven't worried about it.

But it'll be good to get checked out and know whether things are trending in a good direction.

Eye meme

Niobe suggested starting a meme where we post a photo of our eyes. Interesting timing, because I was just playing around with this site, which lets you calculate the odds of your children having any particular eye color, based on the color of the parents' and grandparents' irises. What I learned is that there's no way any child of mine will have my eyes, thanks to my brown-eyed in-laws.

I guess I'm just narcissistic enough to wish that I could look into Sam's eyes and see a reflection of my own. But his are settling into a gorgeous chestnut brown ringed with blue-grey. If I had any shot at getting him to sit still, I'd post a photo, but it isn't going to happen. Sam's eyes are his own, and I should be grateful for this ever-present reminder that he isn't meant to be a reflection of either of us.

p.s. If you look closely, you can see the post-preg skin tag just below my lower eyelashes. Have you gone about having them removed? Is it painful?

Crash

I'm procrastinating on a project that's due today. Ugh, ugh. I should be hanging out with Sam, but I just didn't get this project done early in the week, so I lose my day with my baby, even though I'm home and can pop in to visit him while he plays with his babysitter.

Zev, our young kitty, was hit by a car on Monday. I got the call at work -- Adam sounding sick, waiting at the vet for more news. I raced over, steeling myself for the inevitable news, cursing our decision to let him go outside. "He might die from this," the vet said when I got there, "but I don't think he will." That was the first moment of hope. The xray showed blood in his lungs and a broken jaw and he was in shock and in pain. There was nothing we could do by waiting there, so I drove back to work, feeling the horrible sensation of not being in the place where I should be -- Sam with a babysitter, Zev in an exam room, and me dropping the balls I had been juggling so furiously since I went back to work.

Zev's breathing slowly improved as the day went on and they let us take our battered little kitty home with us, just for the night, so that we wouldn't have to transfer him to the hospital. Up every two hours to check on him, I listened to his breathing and tried to curl up on the bathroom floor, but he just turned away, doped up on painkillers and so far removed. "He's here, but he's not here," Adam said.

The next day, he went back to the vet for more IV therapy and antibiotics, and the vet said the next hurdle was getting him to eat. That took another 24 hours, but he did eat with the help of an appetite stimulant (I meant to ask if it was some sort of marijuana extract so that, when he was feeling better, we could joke about the munchies). And then Zev started hissing at the vet techs when they came around, and then he started wailing for more food, and that's when we all decided that our kitty was coming back to us.

And now he's curled up on the bed here next to me, and everything is right again, my family is in one piece, and I can breathe.