To Elim, On Your Estimated Due Date

Dear Elim,

I thought I would write to you on this, your estimated due date, to say a few things that have been on my heart. Had we not lived in this fallen world, you would be in my arms by now or I would be just itching to have you the heck out of me so we could cuddle and do all that newborn-mommy stuff. But alas, that was not how it was to be.

I want you to know first of all that I love you. And I always will. Even though I barely knew you, I know God made you and I will cherish our short time together before you went to heaven to be with Jesus. A lot of other people loved you and mourned your short life too.

I miss you. I miss what could have been. But, I am so happy you are in heaven now. That you are safe and protected and loved. One day, I’ll actually get to meet you and that will be awesome.

You are a gift. You are an answer to prayers and longings. And you were used by God to teach me big lessons about redemption, real love and how to celebrate well and suffer well.

Because of you, I appreciate new lives more. I appreciate the miracle that it is to see a pregnancy progress and babies be born and children who grow. I want to celebrate new lives instead of hiding them with secrets and fear. I will be honest and say, I also know how fragile life can be and it scares me a little and that is okay. I empathize better with other Moms and Dads who have to miss their kids until they see them again for all kinds of reasons.

Because of you, your Dad and I got to learn to lean on God and each other a whole lot more. We got to grow up more (which I’m sure sounds crazy because we are theoretically grown ups, but even grown ups have more growing to do).  We got to see God do amazing things with what seemed like a terrible situation.  That is what He does, but I suppose you had that figured out already.

I been counting down to this day for many months. Not because of some sick fascination or because I wanted to feel sad or bad. Just out of instinct. I like numbers and it is simple math to know where I would have been with you at any given point. Plus, today’s date has been etched in my mind. And to be honest, I wanted to remember when you would have hypothetically come into this world. Just like I will remember when I knew you went out. Because I care. These are important moments, even though others may not see them as such.

You will have brothers or sisters, maybe both someday. I will be grateful for each of them and know them as individuals. I pray every day that they get the chance to grow up and that it will hopefully be a long time before you meet them (no offense). I also pray that they will all one day meet you in heaven. Know that in my heart you will always have a special place and when they are ready and old enough to understand, I will tell them about you.

You count in my kid count in my heart. So, happy “birthday.”

Love you always and forever,

Mom

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G1P0A1

G1P0A1.

This was one of those weeks where you just can’t help but remember.

I went to visit my family doctor for the first time since we lost Elim today for some general prescription refills.  She did the right thing and asked how I was doing since the loss, if we were trying again and then reminded me that at least I know I can get pregnant.

I know.

She sent me off saying that she hoped she saw me again soon with good news.

Me too.

It doesn’t mean that I don’t exist in perpetual fear of another loss. Some days I wonder about losses that I don’t know about.

But, in that appointment, with our conversation, I realized that watching someone type those letters and numbers was bizarre.

G1P0A1.

In medicine, we have what I liken to a secret code when it comes to describing women and pregnancy. G means gravida. Number of pregnancies. P means para. Number of babies born after 20 weeks. A means aborta. Number of babies delivered before 20 weeks. Some expand it to GTPAL with G being number of pregnancies, T term deliveries, P preterm delivieries, A induced abortions or miscarriages and L live children.

When I learned this system, I found it awful. I found it really tough to keep straight and was forever getting my Gs and Ps mixed up. Plus, it bothered me that A was for both induced abortion and spontaneous abortion. People often specified, but both caused pain and one can have repercussions on future pregnancies if recurrent.

The system bothered me because you could look at those numbers and see joy or pain or fear. At least I could. My heart broke for people who had more Gs than Ps. I hated to ask about losses because I didn’t want to bring up that pain. For me, there was always something devastating about pregnancy loss. It was always something I worried about.

On the other side of the desk, knowing what it means, it still sucks. I think my fear of bringing it up with women was a bit excessive. I was uncomfortable then because it bothered me, not them. I mean, it is a fact of life and it kills me more when people ignore the fact that I had that loss than when they ask about it. I guess I needed to see that for myself.

I was grateful that she cared enough to ask how things were and where we were at.

Still. Seeing it on a screen was weird. Especially when I have thought it before. And knowing that really, months before Elim, there could be another G and A that I suspected, but never confirmed because it all happened so fast. It could be G2P0A2. But, I won’t know in this lifetime. And I think I’m okay with that because I never really knew for sure.

G1P0A1.

What if those numbers never change? What if the Gs change but the Ps never do? What if I match my Gs for Ps from here on out?

I can’t predict the future. I wish I could sometimes, but I can’t.

The things I do know are that I am healthy, that God is good and that there is so much to this life that I don’t understand. I know how much good has come out of our journey so far. That I have grown in leaps and bounds in my faith. That we have been tested as a couple and as individuals and keep coming out the other side. The experience has helped me to love other people in ways that I might not have otherwise had the opportunity to do.

I don’t talk about it a whole lot. I has become easier, but I miss my little A1 every day. Maybe I’ll tell you more about that one day.

It freaked me out to see the letters and numbers on the screen. Sometimes the letters and numbers in your head seem not so real until you realize someone else acknowledges the reality of the situation. In another sense, it made me feel better because it is only one, it is real and it is normal.
God is good. His timing is perfect. I am trying to hope in Him and not my future children (or job or spouse).

Letters and numbers don’t make me whole. They don’t save me from myself. They are just statistics. There are bigger things.

Learning in Ultrasound: A Person is a Person…

I can’t believe how fast February flew by.  It is Medical Monday again, which means time to link up with some other lovely medically affiliated blogs.  Check them out at the link below.

As you may know, I am on a radiology rotation.

A few weeks ago, I decided it was time I go see some ultrasound imaging.  Other aspects of imaging are more comfortable for me (especially Nuc Med for obvious reasons), but ultrasound is my black box, so I figured learning is good.  So, I am doing ultrasound at the hospital where I usually work.  Lots of livers and thyroids and kidneys.

Then, up on the screen pops up a perfect looking 8 week embryo.  Cool, I think to myself, that might be my kid in another four weeks.

Image from babycenter.com.

I then remembered that all of the obstetrical ultrasounds are generally done at the children’s hospital unless there is someone in emerg.  I asked why this ultrasound was done at the hospital we were at.

Its for the TPU replied the fellow.

Termination of pregnancy unit.

My heart sank.

He said I could leave if I wanted to.  But really, this is part of my learning.  Part of life in a hospital and in this world.

I watched him read four ultrasounds of perfect little embryos between 6 and 11 weeks all with heartbeats and the works.  Perfect little embryos that might have otherwise grown up, although it is tough to say for sure because bad stuff happens.

I went home and cried to Patrick because it seemed so sad and so unfair that these babies had to die when maybe they wouldn’t.  It seemed so unfair that so many women want babies so badly and yet here are people who for whatever reason or circumstance don’t or can’t want their own.

Just over a week later, after losing my own baby, Elim, I sat in that department again.

Yet again, I saw babies getting their photo taken to confirm that they were indeed alive (because the procedure is different if they are alive or dead).  I saw one person who had terminated pregnancies 6 times.

I had an overwhelming urge to go in and yell at these people.  To tell them that I am here, working and trying to piece together what is left of my sanity because my baby died before it would have even been very visible on an ultrasound.  That I really wanted that baby.  That it isn’t fair that they get to choose, but I can’t.  To ask a big huge why.

But, I didn’t.

Because that isn’t fair of me (or very professional).

Their baby dying, my baby dying, really, it is all a loss.  Those kids are all with God now.  They all had potential.  They all died because they were made in a fallen world full of brokenness.

That mom may mourn the loss of her child like I do.  Everybody grieves differently.   Maybe not now, but maybe later.  I have heard of the struggles of moms who make that decision.  And maybe she won’t.  I can’t put myself entirely in her shoes.

We aren’t very good at putting ourselves in other people’s shoes.  We are, however, really good at trying to point out other people’s wrongs.

Image from chzbgr.com.

I’m not here to have the pro-choice or pro-life debate.  In fact, I don’t want to hear it because it is often hurtful, overdone and narrowminded on both sides of the coin.  Sin is sin.  Death is death.   Pain and anguish are universal.   We have free will.  That is all on that.

I read this blog post from The Lewis Note called “Why Miscarriage Matters When You’re Pro-Life.”   It was strangely timely based on the adventures of the last few weeks.  Check it out.

I read this post the night after my second day in the ultrasound department when I was really struggling with the value of life and how we see it as a society.

It rocked my world.  Because it is so true, especially in a Christian context, but I am sure it works for others as well.

I have already experienced both the good and the bad sides of this post.  Some people are really nice.  Other people aren’t.  And some nice people say stupid stuff (I sure do).

Thinking on how I responded to people who lost kids at the same point, I think I had empathy and sympathy for both.  I think I did place more value on the aborted baby.  I also think I had more sympathy for that child’s mother because there was action and potential.

Looking at scans, it is the same.  Already dead babies are already dead, so in a way, it seemed less sad than about to babies about to die.

That isn’t necessarily fair of me.

Both an electively aborted baby and a spontaneously aborted baby were both alive at one point and had potential and value.

And then, there is our approach to the mothers and fathers.

Don’t forget the fathers.  Many people do.

Everyone needs love.  It doesn’t matter how voluntary a loss was, it doesn’t matter how old the child was (although this does often impact they way people can grieve and what is considered “acceptable”).  You need people willing to live the grief with you.  To sit it out with you because that is what you might need, even when it is uncomfortable (just like sitting through scans that are upsetting helps us to learn and grow in a different way).

If you claim to care about a person, to care about life, then you should stand by the mourning no matter what they are mourning and no matter how long that what was alive.  If you want some practical suggestions and examples, check out that post.  I am the first person to admit that I tend to project my feelings on others, so if I think something would weird me out, I tend to avoid doing that for someone else or letting someone do it for me.  I’ve learned that I am often wrong and my assumptions were totally incorrect.  If you aren’t sure how to help or love someone where they are at, ask.

I guess I’m learning more than I anticipated on this radiology rotation.

The Blessing and Learning Curve of Gaining and Losing Elim (“ball of cells”)

Image from tochristifrommommy.blogspot.com.

Less than two weeks ago, I found out I was finally pregnant… I called the baby “ball of cells.”  That was my term of endearment.

My medical training made me cautious.  I know that pregnancy does not equal baby.  I know that life is fragile.  I took 3 tests to confirm before I even told Patrick because I wanted to be sure.

It didn’t change our excitement and happiness.  Talking about the future.  Planning for when to tell people. How to make work function.  What we would have to change or do.  Rejoicing.

I knew the longest besides God, of course.  I remember that first Sunday in church when it was still just our little secret thanking God for the new creation growing inside of me and wanting to tell the world and yet wanting to keep it to myself because if others knew, somehow something would go wrong.  The only other person who found out before stuff started going wrong was Patrick and I told him on Sunday night (with what I believe was a very adorable and entertaining card).

Then, we had to say goodbye to “ball of cells.”

I knew something was wrong mid-week.  I re-took a test.  The line got lighter and although this isn’t a perfect system, it wasn’t a good sign.  I told Patrick.

Usually I am the high-baseline, optimistic person.  This time it was him.  He refused to believe anything bad happened to “ball of cells.”  I didn’t want to go to the doctor.  I didn’t want to hear what I already knew inside.  Finally, I went to the doctor who instilled a bit of hope in me instead of flat out dashing our dreams.   I wanted hope.  Cautious hope, but hope nonetheless.

I went for bloodwork.  It was either going to confirm what I thought I knew or make everything better.  I hoped it would make things better.  I needed it to make things better.

Nothing is more bizarre than being congratulated on your pregnancy, being asked about your due date, where you plan to deliver and all that good stuff while sitting there with that gut feeling that your baby is dead.

I didn’t have the heart to tell them.  I didn’t want anyone to feel what I was feeling.

Also bizarre is walking around all weekend not knowing and yet knowing.  It feels surreal.  I have lovely best friends (three of them) who checked in incessantly.  I have a husband who bought me beautiful flowers, cooked me food and was all around over protective.  I don’t know what I would do without them.  I was just glad I wasn’t on call.

Sunday, we watched the Canadian men win the gold in hockey (WHOO!).  Happily, we went to church still not knowing whether we would be parents of a living baby in 8 months.  I was still having some morning sickness and weird headaches, but the acne was clearing up, the cramping was worse and I kind of felt empty.

I prayed for God’s will in my baby’s life and in our lives.  I prayed for strength.  I prayed that we would glorify him in whatever was to come.

We left church on our way to have lunch and board games with friends at our place and there was a voicemail on my phone.  It was my new doctor.  In summary:  My bloodwork was perfect except that my HCG was less than 5.

There would be no baby.

So much for that hope.

It is funny.  I have always thought pregnancy loss was a big deal.  I remember learning about it in med school and thinking how awful it was.  I remember when the first couple I knew miscarried shortly after telling everyone about their pregnancy.  I remember thinking that I didn’t know how they coped with it.

At the same time, I have always been kind of flippant about it, particularly when it comes to me and when it comes to early pregnancy.  I mean, an embryo is an organized ball of cells and odds are there is some sort of genetic flaw that is incompatible with life.  It just makes good scientific sense to clean up mistakes.

I thought calling “ball of cells” just that would make it more clear to me that it may not make it.  I thought explaining to my friends that I was waiting to make sure things were growing or dying appropriately made it all sound more clinical.

But really, there is nothing to be flippant about.

Sure, life goes on.  I know that.  It doesn’t change the hurt of the life that won’t.  Especially because I was one of the only people who really knew it.  And I didn’t even know it that well.  We only got to hang out for about 3 weeks total.  And 2 of them, I didn’t even know it was there.  And it died at some point in the last one.

I feel in some ways like I should care less.  This is technically still a chemical pregnancy (miscarriage before 6 weeks).  It felt different from what I thought might have been my last ?chemical where there was a squinter maybe positive (but in reality probably an evaporation line) and then definite negatives.  It was sad and disappointing, but really not the same as actually existing pregnant for several days when you know something is happening.  It is the difference between thinking maybe and knowing for sure.

It was literally just a ball of cells that wasn’t able to survive.  “It was God’s will” after all.  It was, I guess.  Still sucks though.  Maybe somehow they did have some sort of potential.

I am, in part, glad it happened so early.  Maybe I am less attached than I would have been if I was further along.  People have told me I should be less attached, at least.  That kind of makes me scared for this happening again later in pregnancy.  I have the utmost sympathy for women who loose babies who are more developed and for those who lose children.  At the same time, I am jealous because I was robbed of the experience of even seeing the little sucker on an ultrasound screen.

Sure, I will have more kids.  Sure, I am young.  I know most women go on to have no issues with future pregnancies and get pregnant shortly after something like this.  The statistics are on my side.  I also know I was in the wrong end of the 50% of women who have bleeding in early pregnancy.  Something has to go right.

It is a funny experience telling people you miscarried when they didn’t even know you were pregnant.  Not that we’re telling many people.  It makes them super uncomfortable.  It makes me uncomfortable too (and I often love embracing the awkward).  But, because nobody talks about, I kind of want to.  I know statistically, I am far from the only one to experience this.    I know because, like the big nerd I am, I have read everything I can on the subject.

Because “ball of cells” was so little, I have had a lot of anxiety around whether or not I would see him or her in heaven. Seems silly, right?  I mean, if you believe life begins at conception, of course “ball of cells” was alive and then died.  But, my scientific mind picturing a little cell collection had a hard time picturing my ball of cells chilling with Jesus and my Grandfather.  But, Jesus said, “Let the little children come to me, and do not hinder them, for the kingdom of heaven belongs to such as these.” (Matthew 19:14)  Pretty cool, huh.  “Ball of cells” was a pretty little child, so I suppose he or she counts.

As a result of this, I then got thinking that we should give “ball of cells” a proper name because I am sure they don’t want to be known as “ball of cells” for all eternity.  That being said, the snarky and cold side of me didn’t want to name it because, well, that would make it more real and felt as if I was making much out of little.  Also, I could have other dead balls of cells that I don’t know of (most people probably do), so what about them (I don’t know how to answer this question)?  And, I didn’t want people to judge me (I, in the past would have).  Patrick liked the sounds of naming him or her too, so we went with it.

We named him or her Elim because I have been reading Exodus recently and about how God provided water for the Israelites in the wilderness.  Plus, it is a gender neutral name.

I’d love to say I am all better now, but to be blunt, I’m not.

I’m better in the sense that my body is no longer rejecting the remains of my child.  I’m better in the sense that I know for sure now that Elim died and is in heaven now (while his or her biochemical bits are somewhere in the sewers).

Grief is a funny thing.  And this grief is of a variety that I haven’t experienced before.  Even though I am okay with death, this doesn’t feel okay.  And that is okay too.

I’m sad.  I’m still a bit angry.  But, I feel a whole lot of peace and a whole lot of joy, which is a big testament to answered prayers and the awesomeness of God.

I know, you probably read joy and now think I am taking some sort of pills.  I’m not.

This isn’t smiling, frolicking joy.

So also you have sorrow now, but I will see you again, and your hearts will rejoice, and no one will take your joy from you. –John 16:22

It is more the I’m happy I’m okay, Patrick is okay and Elim is okay.  I’m happy Jesus came and that I’ll get to see my baby again, even though I don’t get the logistics because he or she was just a ball of cells.  I’m happy because I feel protected and loved despite the crap that has gone down.

The really cool thing is that I get something more now.  I have just a little bit of a better understanding of how much God must love us.

Sure, I’m still ticked He didn’t fix Elim and I’m not still barfy and headachey and pregnant (okay, confession… I was pretty excited when I was feeling physically well today).

The Lord gave, and the Lord hath taken away; blessed be the name of the Lord.  -Job 1:21

But, if I can love a little ball of unborn cells that I barely know that much…  So much that I am mourning their death… That is pretty huge.

If God loves me more than that, then I can’t even begin to imagine how sad he feels when we draw away from Him, when He loses one of us.

So yes.  This sucks.  I am not alone in this.  Neither are you.  But, I am growing and learning in my relationship with God and as a physician and human from this experience in ways I definitely didn’t expect.  Funny how gifts come in bizarre packages sometimes.

Image from spiritualinspiration.tumblr.com.