Every day

When I first installed a stat counter, I used to check it obsessively. This is how I knew, one day last year, that someone made their way here by looking for how to stop lactation after stillbirth.

I don't check all the time anymore. I don't even check every day. But every time that I do check, I see that several people end up here, on the post I wrote in response to that first search last year, by searching for various versions of lactation, stopping lactation, milk, stopping milk production, or any of the above with the addition of after miscarriage, or after stillbirth. A barrel of laughs, I tell you.

It's not that I don't know that babies die every day. I even know that in this country alone on an average day, more than one baby will die. But it's one thing to know that, abstractly. It is a whole other thing to have proof, even if only via the internet searches, that somewhere, for someone, it happened again. On a sunny day, or a cloudy one. During rush hour, or in the dead of night. Someone's world stopped. And they are one of us now.

That was one of the things I was thinking about Friday night, after I made the phone calls, but before either JD or my sister made it to the hospital. I thought I might end up having the baby that day or the next. I was hoping I could hold out for 48 hours, but not much beyond that. And what I was thinking about was the encouraging stuff the neonatalogist was saying, the encouraging statistics I knew for myself. I was thinking that this isn't likely to be a bad day for me, not likely to become a mine on my calendar. Not on mine. But on someone's, somewhere.

Earlier that very day there was a comment on the lactation post from a newly bereaved mom who had lost her baby just three days before. It was almost a compunction, when I first read the comment, to think back on what I was doing three days prior, to see it anew as the day someone else's life broke into the before and after.

Even more jarringly, as I walked from the garage to the hospital that day, enveloped in my own worry, something caught my eye. It took me a moment to process it, and by the time I did, the woman holding it was already past me. A memory box. She was holding a memory box. The same exact color they gave me for A.

I stopped. I was both glued in place and wanting to run to her. Only I wasn't sure which one she was-- there were four women walking together, friends or family I couldn't really tell. One held the memory box, another-- one of those plastic hospital bags they give you to move your possessions. Before they passed me I wasn't paying enough attention to know which one was still wearing maternity.

I stood there for a while trying to decide what to do. I wanted to go to her, to say what, I do not know. Certainly not that it would all be ok. Maybe just that I know, and I am sorry.

It honestly took a good bit of time for me to remember that I am pregnant, that I am visibly pregnant (or that I am at the hospital because of that very fact), and that, therefore, I might just be the very last person this mother would want to see right then.

It was somebody else's terrible day. Each day is somebody else's terrible day.

****************************************

Today is the day, gestational age at which A died. Today is also eighteen months since he was born. I was thinking about both of those things all day. But I also knew, kept repeating to myself, that it was a day like any other, that my body and cord accidents do not know about calendars. It doesn't have to become my terrible day, anew. It didn't.

Except I am sure that it did. For someone else, somewhere.



PS. A few days ago, Tash wrote about this very topic-- the intersection of someone's happy and someone else's devastated. It's a beautiful post. Go read it.

On a somewhat related topic, I have a new post up at Glow in the Woods. It is also a bit about the time and space of grief.

Home

I am home. On my couch, in my own clothes, having taken a shower in my own bathroom and a loooong nap in my own bed. Oh, and I had some real food. It is a bit surreal-- on Friday night I sort of bid this mental farewell to exiting the hospital or being at home again still pregnant.

I have to say a huge thank you to all of you funny and warm people-- your words made me feel much less alone, and much less confined. Which is saying something when I have barely left the bed for two and a half days.

The last of the mag was done around 5am. I woke up a few times through the night, but was up for good slightly before 7, when a certain occupant of my uterus, having also been freed from the muscle-relaxing properties of magnesium, went on a long wiggling streak. It was plenty painful, but it was very nice to feel that. He had been moving even on the mag, but not as much, and certainly not with the same force.

There were a few mildish contractions through the morning, but they seemed to quiet down with time. We waited for the cervix check until noon, and when that showed no changes, we were released. Dr.Best called me in my room a bit earlier, and said that he would actually prefer that I skip tomorrow's NST (on account of what amounts to a very extensive one we had over the weekend) in favor of limiting the amount of time I would spend moving or being moved. He also wants me to have that "very low threshold for calling and coming back in." No problem there, doc.

I am actually feeling pretty calm for now. Not having had any significant contractions since coming home helps, as does the moving baby. I particularly appreciated the dance party that began not a minute after I woke up from my nap. Of course I know not to expect this to last indefinitely-- the evening is coming, and this is the week. But I am trying to draw on the reserves that got refilled by those two and a half days of hearing the heart rate monitor thump over my ear.

Complete

I have been beta-complete for 27 minutes now. That is to say, I am 27 minutes past the 48 hours for steroids to take full effect. The mag has been turned down to half the dose I have been on since yesterday afternoon or one third the dose I started with. It should go away entirely sometime overnight.

The state of my cervix will be assessed in the morning, and further decisions made. Based on limited contractions in the last day or so, the doctors seem fairly confident that there is a sojourn of as-yet unidentified length for me on the antepartum floor, and there is even talk of me being sent home. As this is the gestational week at which A died, I am a bit jumpy about that course of action. But I expect that Dr. Best will be by sometime in the morning to heavily influence the decision-making process.

Oh, and when the mag makes itself entirely scarce, I get to have solid food. There is a large plastic container of blueberries in my room, farm-picked by friends and already pre-washed, waiting to be attacked. The hospital, as hospitals are wont to do, tried to convince me earlier today that the bowl of chemically offensive yellow liquid was chicken soup, which I was allowed to have as per clear liquids ruling.

Ha! I am a Jew from the Old Country-- I know from chicken soup, and that was no chicken soup. Let me tell you about chicken soup. Chicken soup is made from, wait for it... chicken. With onion, carrot, bay leaves, salt, and pepper. And that's exactly the soup I did have today, courtesy first of my friend Natalie, and then my sister. My sister takes the prize for consideration in looking after the convalescent, as her and my brother-in-law (dudes, I have a brother-in-law... still weird to say that... they've been married for five weeks now. When does it stop being weird?) replaced the by-then-empty carafe of tea they brought yesterday with two, count them two carafes-- one of tea and one of chicken soup. Labeled for my convenience and everything.

Also? I have the best nurse tonight again. She was on last night, and is on again tonight. She is kind, cheerful efficient, goes way out of her way to make your and your partner's life a bit easier. And she gives massages. All my nurses have been very good (well, except for a lunch replacement today who tried to convince me babies don't die in utero in minutes... aha, I will be sure to pass that along to the pathologist who said otherwise, k?), but Nurse L. really is the grand prize in the nurse lottery.


And finally, as it is still Sunday, I thought I'd multitask and jump back into Mel's Sunday Show and Tell.

 

This is what I saw yesterday morning in my hospital room-- the mag and the IV fluids bathed in the rays of the very early morning sun.


P.S. Dear Teacher, Please excuse the late posting on the picture-- contractions ate my homework the camera made it to the hospital on Friday night, but the USB cord took until today. It's all better now.

The first 24

Thank you, all, for your kind and encouraging comments. We are hanging in, and doing pretty well. So say I, but also the doctors and the nurses.

Since with magnesium I am not allowed to get out of bed, the jig dancing for making it through the first 24 hours and to the second dose of steroids was mostly virtual. And truthfully, it was a little anticlimactic, due to the complete lack of drama in the preceding many hours. Just the way we like it, of course.

Mid morning the cervix check declared it holding at 2cm and 50%, which bought me clear liquids, including jello. Half way through the day they deemed the contractions slowed down enough to lower the dose of mag. Made it noticeably easier to breathe. The evening pair of docs even suggested that they could consider taking me off the mag entirely sometime tomorrow before the 48 hours are up. But I am not up for living quite that dangerously on account of how fast I progress through labors when they actually happen, so I told them I can handle the mag for the full 48.

The doctors are much encouraged by the even further reduction in contractions, so while they are not making promises, they are talking about the negative fibronectin from a week ago and the reduced contractions as good signs for not expecting labor to resume right away after tomorrow night.

The mag is clearly making the baby quieter than usual, but he is still apparently doing well, maybe even better than what they are used to seeing from most babies on mag. Works for me, you know? And did I mention how much I love the sound of the monitor? I believe I did, rather recently.

It is dawning on us that we might, just might, eventually go home with a live baby. So to prepare for that eventuality, JD ran a bunch of errands today, very efficiently. But guess what? We still don't have any baby detergent, and I didn't remember that until tonight. Nice, no?

Well, I'll be damned...

My paranoia turned out to actually be useful.

Had somewhat painful contractions this morning. They, however, slowed to occasional before my scheduled ultrasound. Which went great-- lots of movement, great measurements. So great in fact that I didn't even ask about in-hospital monitoring-- it felt entirely unnecessary. Dr. Best did check the cervix, which was fingertip dilated and 50% effaced, or not much change since the last check, and pronounced me able to go back to the shore. But I was sleepy, and so I went home for a nap first.

One nap, return of much more frequent contractions, and my appraisal of not enough movement later my paranoia had me calling the hospital to come back in. Had a bunch of contractions on the way, and then they slowed down when I was actually hooked up to the monitors. The baby was sort of quiet at first, but then demonstrated the required number of accelerations. I was starting to figure out how long the drive back to the shore would take, whether I was still likely to hit traffic, and what my chances were at the leftover BBQ once I got myself over there.

And then the contractions returned, and I agreed to a cervix check that I refused earlier, when there weren't any. And that check had me clocking in at 1-2cm. And just like that, everything changed.

So I have been admitted, got my first shot of steroids and my first dose of IV antibiotics, followed by the first shot of heparin, am sporting a lovely pair of compression stockings, and am about a quarter way through my loading bag of mag. Which is making me predictably hot and rather uncoordinated with the typing. So this post is taking a while.

A neonatalogist and an anesthesiologist have been by. At this gestational age (33w5d) the prognosis is pretty good even if he came tonight, and only gets better if we can hold the fort for the 48 hours required to complete the steroid protocol. The nurse says she has seen a lot of people hold out longer even after the mag is removed, due to its magical juju of relaxing the hell out of you. I believe that to be a term of art.

One of our friends who was at the shore with us drove JD to the hospital. Monkey stayed, and is excited to get to hang with friends sans parents and that her little brother may actually be born soon. I am not thinking very far ahead, but I am daring to hope for 48 hours, and maybe even beyond. The heart rate monitor is thumping very reassuringly over my right ear. There is also a baby warmer in this room. There wasn't one in the room where A was born.

Magnesium is gaining on me, so I'd better hit publish. I am still somewhat shocked that me being the Protector seems to have come in handy. I had honestly thought that whatever the outcome, it would be in no way affected by my actions, regardless of how desperately vigilant I'd been. Maybe it's the stopped clock, twice a day thing.

Because my mind is decidedly one tracked these days

I have a new favorite sound-- the sound of the heart beat monitor. In general, but more so the one on the maternity floor. It's the sound of respite, of assurance, of someone else being responsible.

Responsibility feeds my fear. Not to sound overly dramatic, but I think I am about to. I feel like there are three hearts on a string around my neck-- mine, JD's, and Monkey's. It's Monkey's heart that I am most afraid of breaking, again, though it may be JD's that is the most fragile. Neither of them would blame me, of course, if. Neither of them would even want me to feel responsible. Well, I am sure JD doesn't, and am pretty sure Monkey wouldn't, if I could explain this to her and ask for her opinion. Which I am not going to. But their desires have very little to do with the reality I inhibit, and that is that I am the only one who can tell, in the middle of the night, whether we still have a chance at a take-home baby this time.

The panic I wrote about in the last post is not a sledgehammer. It does not come down all at once and full force. It creeps. I imagine that is what the approach of Dementors must feel like. And it occurs to me that what I am trying to do to keep it at bay is something akin to the Patronus charm-- conjuring up that kick, willing it to come before the Dementor gets close enough for me to lose all reason, for the images to gain hue and depth, to turn from what I know to be no more than sketches to what I perceive to be a cruel preview of This Is Your Life, Redux.

In the hospital the monitors in the room are connected to the monitors at the nurse's station, and if the heartbeat trace is lost, the ones at the station beep. Loudly, I presume. The nurse then comes in and talking about how at this gestational age they are still small enough to be able to get away from the monitor once in a while, readjusts the sensor to where the sound is heard again, the numbers jump, and the trace in uninterrupted. What keeps me serene through these little games of hide and seek (well, other than the kick that usually precedes him being able to get out of range) is the knowledge that there are two ORs just down the hall, and two teams of OBs on the floor at all times, a high risk MFM team and a regular old OB team. And that Dementors are not allowed on that floor.

In as many times as I have gone to the hospital this pregnancy, I have not gone in, yet, simply to use my favorite sound to sooth the racing mind. But the days between appointments, they drag. And we are at the shore this week. A short drive back, but longer than from home, and far more at the whim of traffic gods. Tuesday I drove to the NST, ran errands, and then came back again. It really is a reasonable drive, and there is a smaller affiliated hospital along the way that can transport me to mine if things get dodgy. But man, it was hard to leave that safety radius of the 20 minute commute.

I failed the NST on Tuesday, and was rewarded with a BPP, which I passed, but not spectacularly. I am worried. I may be worried enough that I am coming up with new things to worry about. I have a big ultrasound tomorrow. Not just a BPP, but a growth scan and everything else we can throw into the pot. I am planning to ask whether the baby could be getting overwhelmed by all the contractions, whether having to be reactive to them is taking its toll, whether putting me into the hospital to be monitored for 24 hours or so wouldn't be a good idea. I came up with this new worry yesterday, during the day of many a somewhat painful contraction. But since last night they have been no more than intermittent, and now I am not so sure-- is that even a real concern, or am I just making shit up for that day pass out of Worryville?

Protector, The

Early evenings are the worst for me. The day is winding down, the list of remaining activities is short, and the inevitability of yet another night is staring straight at me. I spend most evenings on the couch, with my laptop, but really mostly thinking whether there had been enough movement in the last 10 minutes, half an hour, hour, and how has this day been, overall?

I worry if he moves "too much" too. In reality, I don't think we have had anything closely resembling the frantic activity of the night before A died. But we have had stretches of time where this one has rolled, flexed, punched, and kicked enough to make me wonder, for just a bit.

Nights. Nights are not easy either. The absolute best way to wake up, whether for a bathroom run or for the day, is to have the consciousness of the world come in the same breath as a consciousness of a movement within. To wake up and know, absolutely know, that he is still alive-- those are the rare moments of almost bliss, moments of reassurance without fear, of existing in a place that fear didn't get a chance to enter, a place of peace.

Far more often it goes like this: wake up, realize it's a bladder call. Make it out of bed somehow. Often not in any way that can be described as optimal because at least one of my hands is engaged in belly-touching, something that often encourages the baby to respond. But not always, and not nearly right away. So I stumble to the bathroom, do the deed, wash hands, reluctantly letting go of the belly for that, walk back, now with both hands on the belly, get in bed, turn onto one side or the other, use the opposite hand to keep holding the belly. Rub a little if need be. Try to keep the panic from closing my throat, try to keep the cascade of images from beginning to run through. I can't, no matter how tired, fall back asleep until I get that proof of life. So far, it has always come.

Panic, throat closing, image cascade, these happen in the light of day too. Driving in a car, when a realization hits that it's been three of these NPR segments since the last kick. And so one hand goes to the belly, and I drive with the other. Which, if I tell you that I drive a stick, should impress you. But not nearly as much as the idea that during these episodes I am also driving with maybe 10% of my mental acuity dedicated to that task. Ok, I take that back-- last part should scare terrify you, at least if you live anywhere near me.

My couch is also an excellent place to feel panic. The doppler helps, but not as much as you would think it would. A had a fine heartbeat the morning of the day he died. He just wasn't moving much.

I wonder sometimes whether my fear would be less if A's story had been different. If my primary problem was preterm labor, would I also be this obsessed with constant reassurances in the form of kicks? If the knots, the notoriously hard to see on the ultrasound umbilical knots, weren't what actually killed him, would I be less tightly wound? If there wasn't also an infection, would I be ok with less uniform and less consistent movement?

At my first NST this week, the nurse in charge of the room handed me a small Jeopardy-style clicker to press every time I felt movement. The machine recorded my clicks as little arrows on the strip, right next to his heartbeat printout. When she came up to me to talk about the fact that we will have to give him a bit more time because he seems to be asleep, she said that I was feeling a lot of movements. She meant that I was clicking for tiny movements others wouldn't notice. I tried to suppress the smile I was expecting to come out a lot more sad than wry as I thought "you have no idea, lady."

As I have seen the veterans tell others before, getting to the part where the monitoring is twice a week-- an NST on Tuesday and a BPP on Friday-- has helped. I no longer feel entirely and fully responsible. Only I kinda do. The appointments help for a bit. They should, in all honesty, help for longer. A BPP is supposed to be good for about a week, but it only really works for a day, maybe two with me. And only if it was Dr.Best doing it. This week he was out of town, and I didn't like the tech at all.

The contractions I keep having add a strange dimension to the whole thing. They can be tiring, they can be annoying, they can even be significantly physically uncomfortable. But what I realized today is that my biggest concern (funny, since it seems to have taken me long enough to articulate that to myself) is that I am afraid that they are distracting. I am afraid that if I pay attention to the contractions, as I am supposed to, or so my doctors tell me,-- how frequent are they, how strong, are they changing in any way-- I am afraid that if I pay attention to them, I may relax my mental grip on paying attention to movement.

So this gig as The Protector. It's tiring. It's scary. And most of all, I recognize, it is mostly futile. The chance that I can do something, that I can affect the outcome, that I can save his life, the chance is minuscule. But it's not zero. And so I persist. I wonder, though, how rational I am about this. Even if the chance was zero, could I let go? From where I sit right now, I don't think I could. I would, I think, want to be the first to know.

I was chatting with another bereaved mom when I saw the post announcing the arrival of Wannabe Mom and Dad's new son pop up in my reader. I think we exhaled in unison. And then I typed the first thought that came to mind: She must be so relieved. Now, how fucked up is that? My first thought was relieved, not happy. Not ecstatic, not crying in joy. Relieved.

That must be, I later thought, because I can't think past that for myself. I will be relieved when this gig is up. I also told JD I will need a drink. But maybe a good cry will be enough.

The way we deal

Monkey is showing interest in chess these days. Which is fun, because JD and I met playing chess ridiculous number of years and an ocean ago. We made a mistake of showing her how to set up a full board a couple of years back, from which she concluded that that there was the object of the game-- to put all the pieces in the correct spots. So we had to wait it out, and these days she is more willing to learn about what the pieces do and how they can interact. We are just starting, but last week, while I was on the couch, and she was on the floor with my old tournament roll up board and a white knight, we tried the how many squares can you make it to on the board without ever stepping on the same square twice problem. We used game pieces from a board game to mark the squares she visited already, and with some help, she got 53. Not bad. Not bad at all. Yesterday we worked on bishops and their interactions.

It's fun to see her notice patterns. I am a patterns girl myself. Patterns and numbers. I see them, I notice them, I like them. In grief, I think patterns and numbers can help, some. The dates, monthaversaries, anniversaries, they can provide structure, they can provide outlets. But sometimes, they can also drive you a little mad, or fill you with anxiety, or both.

Niobe has been telling me for well over a year now that not having dates to focus on can be a calming thing. Never have I appreciated her point more than this weekend, when I came to a sudden realization that, should I still be, you know, pregnant with a live baby then, the DBD (dead baby day), 34 weeks 4 days, the gestational date at which A died, mapped onto this pregnancy? It will fall on July 31st. Also known as 18 months.

I don't know what to do with this realization. I don't know what I would want to do on that day, if I get a choice. I don't know whether I would want to have a monitoring appointment then, or, perhaps, a lobotomy. I just don't know.

What would you do? If you had a subsequent pregnancy already, did you mark the day or did you let it slip? Did it coincide with anything else for you?

The first one to tell me I am nesting gets it

I am off restricted movement and off the sauce terbutaline.

BPP yesterday went well. Cervix is still looking to be about 4 centimeters long and posterior. Dr. Best also expressed his deep and abiding dislike of terbutaline, for all the reasons I already saw last weekend while PubMeding the thing from my couch. There are no studies to show that it prolongs pregnancy, while there are plenty of studies that show it causing hyperglycemic reactions and raising heart rate in the mother (check and check), and, more disturbingly, some reports of impact on fetal hearts with prolonged use, as well as some small studies of neural impact in rodents. The last, luckily for us, preferentially impacting females, and at what I think is a much higher dose than what I was taking. Of course I wasn't taking it for pre-term labor (since I am not, at least for now, in PTL), but rather for symptomatic relief, and I think I had taken a total of three pills since Tuesday afternoon. But I am not to use it anymore. I can use Tylenol, Benadryl, or Tylenol PM (which is just Tylenol with Benadryl). Lovely and appetizing choices all.

After Dr. Best mentioned that while it is pretty clear now that terbutaline is not doing "what we thought it was doing," it is still a standard of care in many places, and that in most community hospitals if you come in with contractions, you are likely to get about three shots of it before you ever see a doctor, JD spent the evening pondering how come doctors do not have professional responsibility standards that would require them to keep up with research and changing knowledge.

I spent my evening contemplating the other thing Dr. Best said-- that after tomorrow, which would mark 32 weeks, were I to go into actual labor, he would only attempt to slow it down (with magnesium, yum!) enough to get steroids into me. After tomorrow, people. Nevertheless, I am surprisingly calm about that, likely, I think, due to the fact that the baby is supposedly pushing 4 lbs by now. Probably also a little because, as scary as that would be, it would mark the end of my exhaustingly solitary shift as the Protector. I am still trying to formulate my thoughts on that. Hopefully in a few days.

We also finally have guidelines for when to go in that I feel are concrete enough to be useful. Any time we want to check on the baby (said for the upteenth time, but finally seemed to have registered with JD who has felt a little guilty for going in so many times with what has so far always, thankfully, turned out to be false alarms. I have never felt guilty about it, though I have, on occasion, felt a little silly after an innocuous explanation for my scare of the day had been revealed), and if contractions feel qualitatively different. This last bit is good because the four or five an hour guideline is utterly useless to me, seeing as if I get going, I contract every three to four minutes. I do that when I am in labor for real too, so it's not that surprising, but it does make decision making much more difficult than it is meant to be in these cases. I am also not officially under house arrest anymore, but rest and hydration are my main weapons for when contractions do show, so it is all relative.


I was all happy last night when 11pm rolled around and there had been no contractions. I was getting cocky thinking they have left me alone. But they eventually showed up, and, annoying fuckers that they are, stayed the night. I didn't take anything overnight because I had to get up early and help get JD and Monkey out of the house for the two hour car trip to an all-day Bar Mitzva festivity in a neighboring state. They were gone by 7:30am, and nearly two liters of soda water and an hour and a half later, so were the contractions. Finally.

Since then I ate, read some blogs, finished loading the dishwasher that was almost ready to go, ran that, did two loads of laundry, unloaded the dishwasher, loaded what dirty dishes remained, washed the few wash-by-hand items, you know, by hand, wiped down my counter, ate again, and am now planning to head upstairs to take a shower and bring down the two semi-scary piles of laundry that have accumulated there since my dances with contractions began. I think this is all due to finally being officially allowed to do stuff. And I would caution those of you who are tempted to offer a different explanation to first review the title of this post.

Dispatch from couch central

Thank you, all, for your kind words and warm wishes. I have been spending my confinement attempting to figure out just how long I can go without taking my terbutaline (current hypothesis is skipping every third dose-- further confirmation pending), keeping up with blogs, and drinking enough water to enable myself to float to the bathroom-- sadly, and on account of all the water I drink, my most frequent destination.

Oh, and digging through PubMed-- new post, full of links and sciency stuff, but also, hopefully, practical advice about an aspect of managing a subsequent pregnancy, is up at Glow in the Woods.

Modified

My uterus has been acting cranky. It started last month with these long Braxton-Hicks type dealies that would come on and stick around until I found a way to recline. But they didn't seem to be doing anything, and so I was reminded to rest, hydrate, and call if I got more than four or five real ones in an hour. Will do, no problem, see ya later.

Then, Tuesday last, just that happened, and off we went, my uterus, its occupant, and I, to the triage floor. Contractions, why yes-- here they are on the monitor. But my cervix was heavy into mixing its metaphors, all of them helpful-- it was, it seems, auditioning for the role of a tight-lipped secret service agent guarding Fort Knox. (Bon, my friend, I want you to know that I would never covet the title that is rightfully yours, and so we, my cervix and I, are staying the hell out of the Miss Cervix Universe '08 pagent.) And so with negative fibronectin test to boot, we all headed home to vigilantly keep watch from lazy about my couch.

Over the next several days only sporadic contractions here and there interrupted my regularly scheduled freakouts. Then on Sunday, seemingly simultaneously with the final whistle that brought the European Cup finals to its just end and ensured a substantial boost to the entire liquor-related sector of the Spanish economy, there came one of them annoying contractions. Not five minutes later our local station cut into the broadcast for some minor announcement like a severe thunderstorm watch for large chunks of the state, and I started to laugh at JD's righteous indignation at having his broadcast interrupted. Only it hurt. To laugh. On account of another damned contraction.

A few more and a phone call later we were on our way to the hospital. Where it turned out that both Dr.Best and my friend the OB (hm, he needs a name, it seems... ok, then, Dr.Friend) were on the floor that day. Reassuring, yes. Cervix doing ok, fibronectin negative, lather, rinse, repeat, go home. Have a number of contractions on Monday. See Dr.Best for the regular office visit Tuesday morning. Find out that the nurse on the floor Sunday forgot to send my urine for culture. Do that Tuesday. Schedule this week's BPP for Wednesday, and then for Fridays from then on. Get reminded to call anytime, if anything at all is funky. Have a great BPP on Wednesday morning, prominently featuring a long-looking cervix and a very active baby.

Leave work Wednesday afternoon because damn, those contractions seem annoying, and where is my couch? Thursday stay at work sort of late, periodically noticing somewhat stronger contractions. Have a nice rest on the couch in the evening. Start noticing new batch of contractions late in the evening. Fall asleep on the couch considering whether or not to call. Wake up and realize that since you were able to sleep, they must have gone away. Crawl upstairs, change into pajamas, get into bed, and realize that you can't sleep because of somewhat frequent and fairly annoying contractions.

Roses are red
Violets are blue
We've got contractions
And how about you?

Call, go in. Arrive around 3 in the morning. Get to learn first hand why residents are not attendings.

The resident I got was very nice. Did all the same things-- fibronectin test, manual check, monitoring, manual check again after the results come back. Only, wow, did it hurt. Wow, wow, wow. Let me just say that I sincerely hope the man gets some more training before he is somebody's doctor for real. Just saying.

But also? I could definitely feel the blasted contractions. And they came every 3-4 minutes. And I asked him, when he told me that once again I could go home and call if things didn't improve by, say Sunday or Monday, I asked him what happens if they don't slow down and I can't get any sleep. Ummm... you can take some things, like Benadril, but you should call first to make sure they are ok with Dr.Best.

So I change back into my own clothes, and am sitting there waiting to be discharged, when the nurse comes to tell me that the attending decided that he doesn't like the look of the contractions on the strip, and they want to keep me another two hours and check again. Ok-dokey. Change back, get the monitors back on, and somehow fall asleep. For almost two hours. Heaven.

I woke up to realize that the contractions were still going at about the same clip, only less strongly, which is probably why I got to sleep. Round 3 of Resident IronGrip all up in my business declared my cervix holding steady, and I was expecting to be sent home any minute with the same nebulous-sounding instructions. Only the intensity on the mo-fos picked right up after the exam, and I was starting to wonder whether I could get away with convincing myself that sleep is not really a necessity.

And then the nurse came and took the strip to show the new attending, fresh at the start of her shift. And then the attending herself came to talk to me, and lo, I was in love for she had non-nebulous things to say. Your cervix seems to be doing fine, she said. But you are contracting every couple of minutes, and we think that's at least uncomfortable. So we want to give you trebutaline (hallelujah!), and what do you do at work? I think you should work from home all next week. Not a strict bedrest, but more like a modified house arrest. Relax as much as possible.

So that is where I am now. Three doses of trebutaline later, I get only an occasional contraction. I do get the promised slight jittering soon after taking a dose. But I took an almost three hour nap this afternoon, and am heading up to bed for the night right soon. And during the day, my couch and I are going to become even closer. Which is kind of frightening given how much time I have been spending with it already.

Before I left the hospital I asked about those manual exams, and bacteria, as in possibility of introduction of the same where it shouldn't go, and antibiotics just in case. I heard back from the office on Thursday that the culture from Tuesday was negative, and given that, they didn't think I needed antibiotics. But it seems after I left, Dr.Attending looked up those urine culture results in detail, and decided that given my history and the ongoing contractions, and the small number of bacteria that did show up on that test, it was best for me to take an antibiotic. So I am.

Damn, this is long. I should've stuck with the short version, I think: Contractions, frequent, not productive, trebutaline to go, antibiotics too, couch comfy, still need sleep.

Hope everyone is enjoying their weekend.

Agency

If you listen to scientists, particularly biologists, talk about their work, you might be surprised to discover the rich secret life of things you rarely give any mind to. DNA doesn't like to be single-stranded, you see. Some proteins just hate being in solution or else they refuse to form crystals. And do you know how hard it can be to put together a buffer that will make your particular PCR reaction happy?

This is called anthropomorphizing, ascribing human form or attributes to non-humans, and is something scientists are very fond of doing. Of course when experts do it, they understand what the other actually means. These phrases are a shorthand for "the laws of physics and chemistry make it energetically favorable for X to do Y." It also, IMHO, makes for a much more enjoyable conversation. But that could just be me.

When I switched from bench science to research and practice of science education, it quickly became clear to me that anthropomorphizing was a very dangerous thing to do around novices. There is a certain mystery to the systems that can't be directly observed, and there is a certain amount of intellectual inertia at play for students entering a required freshman class. These two things combined can result in a student remembering his TA emphasizing that DNA molecules prefer to be double-stranded, but being entirely unable to explain why that is based on the structure of said molecule.

I have been mindful of that in my teaching ever since. In making my curriculum materials, I emphasize the basic underlying reasoning. If I do slip up in class and use an anthropomorphism, I stop myself immediately and ask the class to say what it is I actually meant there. Clarity. I seek clarity and I seek to impart clarity.

This is what came to mind for me when I realized I was feeling uncomfortable with talking about the baby doing things that result in me freaking out and needing medically-enabled reassurance. You know, not kicking as much as I would like, flipping to a head up, face in position one day (causing me to look smaller in the midsection and lose my mind with worry until the emergency ultrasound that explained it), things like that. Or the contractions, which are not even technically his fault, except they do seem to correlate with the days he spends head down.

Earlier on in my misadventures in worrying, in fact right around that first trip to the labor floor, I asked B how to say "little shit" in Hebrew (harah katan, in case you are wondering). I thought it would be clever to call him that when I freaked out, you know, after it was clear that nothing bad has happened. I even did that a couple-three times.

And then I realized that it didn't feel right. I wanted to make jokes. I wanted to be able to say that I will duck his allowance for this or that infraction (as if! there are no allowances in my house, at least not yet). But I can't. I.just.can't.

As near as I can tell, I am seeking clarity again. For myself and all around me. When A died, a seven-year-old son of a friend of ours asked his mother what happened, and then asked how come the baby was playing with the cord-- didn't he know long rope-like things were dangerous to play with? This past winter it came out (and was dealt with) that Monkey was a little upset at A for pulling his cord.

If this baby doesn't make it, if anything goes wrong, I don't want to have to remember myself or anyone else faulting him, even in jest. Whatever he is doing, he is not doing it on purpose. There is no intent. There is no agency. I am being protective, over-protective even. Not his fault. Wasn't his brother's fault. I still can't visualize the good outcome to this pregnancy. The bad? It's familiar, and terrifying.

I have apparently appointed myself (or have accepted the mantle of) the protector. I will talk about that soon-- there is much to say. But for now, the relevant point is that this is also something I am apparently keen to protect my son from-- any implication of culpability in the eventual outcome, whatever it is, or even in any individual freakout I engage in along the way.

I have been thinking, though, that with this, as with everything else grief-related I have found so far, there is always more. More than one reason, more than one level, just more. I did make one joke, after I stopped shaking following that emergency ultrasound that showed the baby assuming the weird position. I called JD to tell him, and in the nervous energy between us, we spontaneously created a joke the punchline of which is that as the punishment for his in-utero antics, upon his live birth, we would subject him to what amounts to a standard Jewish religious rite.

I thought it was funny because, see, nothing extra would actually be happening to him. We are just, for now, calling it the punishment. Ha-ha, isn't it clever?

My friend Natalie called me when I was on my way to that ultrasound, so she knew what I was worried about, and she called later to check on me. I told her it was all ok, and told her our new joke. She laughed for a minute straight. Another friend I told the next day laughed too, this full, deep, appreciative laugh.

I get how and why the joke works-- I constructed it after all. What I was trying to figure out was why it didn't seem nearly as funny to me. It's the levels thing, those damned levels. The joke, see, it's predicated upon this baby being born alive. His brother did not get that rite. His brother couldn't be subjected to any of the other punishments we could conceivably joke about either.

My boys, right now, are both just babies. Babies who, by definition, lack agency. And here I am, with this enormous love for both of them, teetering on the long brink where everything will be decided-- do they both stay babies? Do we get to raise one of them? They can't do anything about it, either of them.

And maybe that is another level. I felt such overwhelming gratitude that this baby didn't die before or during my sister's wedding. I felt so relieved, but also grateful. And having nowhere in particular to direct that gratitude, I think I felt grateful to him. But he didn't do that either, he had no active part in surviving so far. Maybe what I am doing here in focusing on agency is reminding myself that if he makes it, it won't be because he did anything to cause it either. That he didn't do anything better than his brother did.

Whew. Who needs therapy when you've got a blog?