A Wide Open Heart

Steel was forged by fire.

That was a saying my friend Karen mentioned to me yesterday. She reminded me that my heart was ripped open by what happened. In talking about how obstacles make one stronger, she asked me to think about what Sally Ann and this experience have taught me. Ok- people are always talking about what we learn from a terrible experience. It almost seems like a silly exercise. Let me try on that theory and really think about it.

What I learned:
**How very strong I am
**I am an amazingly great mother and would go to any length to save my baby- nothing off limits for my child
**I can love more deeply than I ever knew I was even capable of
**What a great, strong man my husband is and how intensly he loves me
**I am not alone- there are loved ones and strangers that have reached out to share in my pain and to give me hope. I have felt the true generosity of others
**I am a money magnet, convincing my HMO to spend 50K to fly me home to the states-if I can do that, I can do anything, or at least may have a successful future in sales
**I could get pregnant easily- even without IVF- and if I can do it once, I will do it again

These are all great gifts that I am grateful for having learned. Could I have done without these lessons? Certainly. No doubt about it- lessons I didn't need to learn. I would much rather have a baby and be ignorant regarding any of the above.

A Penny For Your Thoughts

They say I wear my heart on my sleeve. I also wear my daughter around my neck. Call me morbid. It is somehow very comforting that I can keep her ashes safe. I feel closer to her. Damn it- that's all I got. Chris at the funeral home gave me the locket for free when he did the cremation. The whole thing was free actually. The locket is silver and gold and in the shape of a heart. On the back, it is engraved with Sally Ann's name and birthdate. I am always pleasantly surprised by the generosity of others. The world is a good place- at least more good than bad.

A week ago, I reached down to find the locket missing from my neck- it turns out it is a screw top and I guess I was fiddling with it so much, I screwed the darn thing off. I went into a tailspin. How could I have lost my daughter TWICE? I finally found her in my closet. The locket was on its side, some of the ashes had fallen out and lay next to the locket. Boy did I feel like a terrible mom as I tried to place the ashes back in with my fingers. Sally is back on my neck now and I won't do that again!

Thoughts keep coming up, swirling around in my mind. I still have tons of doctors calls, appointments, medical records sent here and there. It feels like insult to injury- I can't just move forward. I keep having to re-hash, follow up, discuss next steps. I thought my next steps would be a crib and a car seat.

I hope my next pregnancy is smooth and easy. Breathe in, breathe out. Some questions have no answers. Just keep on keeping on...

The Club No One Wants To Join

Women like me who have had premature preterm rupture of membranes (PPROM) have a cute little name we use- PPROM Queens. It kind of lightens up the reality of what happened. It almost sounds like a sorority except no one ever asked to join it.

I have encountered so many wonderful and caring women since I started this blog- for this I am ever so grateful. I have met women who have had almost the exact thing happen to them (not the puerto rico nightmare, but the PPROM part). I have come to know women who have experienced the many possible things that can sadly cause a pregnancy to end with "fetal demise." I have also met women who had normal pregnancies, only to watch their special babies die days or weeks after birth. No matter when or how it happened, we are bonded together in this surreal space. We are women who all experience that raw feeling- emptiness, dread, longing- and yearning for what might have been.

A woman with a dead baby- we sit together behind a curtain. I never even thought I would be part of this club and didn't really care to peak behind the curtain to see what was there.

I think that the whole topic makes people uncomfortable. What do you say to her? What if I say the wrong thing? Maybe I should leave her alone until she is ready- she knows I am here for her. All these concerns have the opposite effect that was intended. In fact, they actually increase the woman's loneliness and isolation. But even with all the support and love in the world, the road is a lonely one that must be travelled alone. I am on that road now and wonder where it will lead.

I am so open and ready to hear about how others have coped with this kind of loss. What can I do to get out of my own way so that I don't make Sally Ann's memory something that overwhelmingly pains me? I want to be able to think of her and smile, knowing that she gave me the most special of gifts-hope.

What suggestions do you women out there have for me? My enquiring mind wants to know.

"Every time I think I'm out, they pull me back in"

Imagine if you will, an anguish so fierce, you can feel it from 10 feet away. There is quite an awesome amount of uncontrolled power in a grieving woman who has lost a child. It is almost akin to a wild animal.

Picture ear-piercing shrieks, breaking down in tears repeatedly, even threatening to quit: that was my day at work.

I started off on the wrong foot when my therapist had to cancel. I was, at first, ok with the missed appointment. As the feelings began to quickly overwhelm me, I should have focused my rage and blame on her- that could have been a healthy exercise. Instead, I chose to direct it to those I came into contact first: my boss, an employee, and a couple co-workers. I then found out that my reproductive endocrinologist will need me to wait another month, until October, to begin again. I will need to have some tests done prior to restarting fertility treatment and they want me to wait a month before doing this. I had my heart set on next month. It was like my happy red balloon was busted- here I am again with no control over my own life.

My husband called at a good stopping point in my rage to let me know he may need to take a leave of absence to get through this. Oh yeah- now I remember we are supposedly in this together. I keep forgetting and thinking it is all about me. At least that's what it feels like. How can he seem so calm and feel so bad?

I have come to realize tonight that the healing process is not a stepwise progression as I had thought it might be- and counted on to be. I imagined each day I would be slowly plugging away, taking one step in front of the other, feeling a little bit better and a little bit better. Then one day in the not too distant future I would be talking about how far I have come.

Rather than that, the process seems to be much more of a spiral. To be sure, there will be times when the hurt is less, when I actually feel happy (or at least calm). And then there be a point when I will circle back to a place of pain and trauma. The spiral, however, doesn't mean I am back at square one. I see it more like a tornado or a coil: I spiral back, but I now find myself in a new place, a slightly changed woman from the last time I was immersed in the grief.

I am grateful for the little things- like that the day is coming to a close. The anti-anxiety pills come in handy on a night like tonight. It may be a band aid, but it sure works in a pinch.

Cycles of Life

I got my period today. At first I was scared. I never fully stopped bleeding since the day I gave birth. The last couple weeks were mere spotting though. I figured I wouldn't get it for a while, but when I called the doctor frantically, she said that it usually comes 4-6 weeks after delivery. It's been 4 weeks, 1 day, 2 hours, but who's counting.

I suddenly feel hopeful. I was told that I should have two periods before I begin trying again. This is number 1. If all goes my way (which I cannot say it has been lately), I have 28 days to go. I will hope that my mom and Sally Ann are pulling for me on the other side- maybe they have some influence that can help me get knocked up again- and quick!

It is funny- thoughts like this make me question life and the universe. A woman who had gone through a similar experience wrote "together, let's figure out a way to have this bring purpose and meaning to your life." It was the same words told to her when she was in my shoes.

This bringing purpose and meaning to my life?

How can I? At this point When I think about what happened, all I feel is despair- where is the meaning? I am definitely not there yet, but at least I didn't find those words offensive. I think I am on the right road...

Hangover Saturday

Didn't quite feel like myself this morning. Must be the result of the grey goose Friday. My baby dog Lola nudged me a little too early than I wanted to move. Ugh! I found myself off balance and sore as I moved around the house. Nothing a day at the spa couldn't fix.

I had made wax and massage appointments months ago and it couldn't have come at a better time. No fun that my pregnancy massage was changed to a "normal" one, but my massage therapist is top notch and the good part is that I can go for 80 minutes now.

I somehow was able to find the humor in my ignorant waxer's attempt to make me feel better after the "what's new" question was answered in an unexpected fashion. I should have said "nothing" but I was concerned that she might remember that I had been pregnant and ask about it. Now I realize she probably wouldn't have.

Let me see, what was my favorite comment that she made? It was like a parade of all the stupid, insensitive one-liners wrapped up into a one hour session- and I couldn't go anywhere, I was naked from the waist down and only half waxed at the time. For those of you who don't know, please study this and do not use any of these lines in an effort to make me feel better:

--"Well at least you were not farther along or it would have been harder- you could have been more attached." Loss at any time is great. How could I have been any more attached than I was? Sally Ann and the future I dreamed of, snatched in a moment for unexplained reasons. The only response that came to mind was from an old Saturday Night Live Dan Akroyd line, "Jane, you ignorant slut!"

--"You could always have another one." Like that will make it better. Just have another one and you will forget the loss of your child. I worked 3 years for this one.

--"After my baby was born, I had to have a D&C and that hurt too." You have got to be kidding me. How do I even respond to that one? This woman was a teenage, unwed mother who is now in her 20's. She doesn't have a clue and I think silence is in order rather than screaming at her with all my pent up rage. She is only 3/4 of the way through the wax, so I better just keep quiet.

--"Do you want a girl?" Right now I want a live one- that would be good.

--"I don't know if you have read any fertility stuff but" -Let's see: this was only my life's dream since I can remember and I have been trying to conceive since 2005. I think I may have read a thing or two, and met with 3-4 specialists, but why don't you share with me your infinite wisdom.

--"If you have sex 4 days before ovulation, you're more likely to have a girl." I wish these types of issues were my biggst concern.

To add to the mortification I was feeling, I started to bleed in the middle of it. Nice. I keep wondering when the spotting will finally stop- it keeps stopping and then starting again. The waxer was actually tactful about that. She suggested I excuse myself to the bathroom to address it, and I contemplated making a run for it. When I got to the bathroom I realized I had to go back- there was still wax on me and I would have looked a little lopsided. Drats! Back to the stupid whore!

The massage therapist made it all melt away. I could have stayed there forever. I feel great now and the morning is no longer affecting me.

4 weeks to the day that my baby died and I here I am. I read a line in a magazine while at the spa. It seemed particularly poignant. Bad things will happen- that is inevitable. But so will good things. And I get to choose what I will focus on. Today, I'll work on focusing on the good. Wish me luck!

Blowing Off Steam

Sometimes every girl needs to blow off a little steam. Mind you, blowing off now is distinctly different than my single days. Tonight, I thought trying my hand at some grey goose and a hot tub with my husband might be fun.

As the night wore on, it was me, my dvr'd episodes of Swingtown (CBS on Friday night at 10 pm est), and dancing to great 70's songs. I would have felt silly with others around, but the old friend called the "vodka drunk" kept me company. I find myself at 2:00 am with my husband sleeping like a baby. Oh- I almost didn't mention it. Got close but I am not quite there yet. Baby. For now, my baby will be Lola- my sweet little doggie. Not the same as part of me, yet she loves unconditionally. Sweet dreams.

The Wise Ones

When my mother was dying last year, she spoke with a Wise One. She couldn't figure out why this was happening to her. She had stopped smoking over 20 years before and now was lying in a bed with end-stage lung cancer. By most accounts, she was a miracle. She had lived almost 4 years when 50% die in the first year. Only 15%make it 5 years and she wouldn't be one of them.

"There are some questions that have no answers" the Wise One said to her. While it doesn't solve the question, there is something comforting in that statement. She held on to that, as did I, until the day she died.

I found it surreal when I was in the hospital and the resident hospital Wise One came through on his rounds. Actually, I had requested his visit. I talked through my story and my options. He unequivocally said that I had no choice but to induce labor, to choose life and health for myself. He said that the choice had already been made by what had occurred. I broke down crying, not understanding how or why this could have happened. Almost a year to the day my mom died, he uttered those same words.

There are questions that have no answers.

I was reading about a fellow blogger's experience today. She has been such a comfort with her compassionate words and thoughts to me over the last several days. She spoke about what become the milestones of your life- those experiences that forever change you.

Before and after.

I will never be who I was before my baby died. I can't go back to that woman. Since the book of my life is only partially written, I cannot say for sure whether that will be a good or bad thing over time. At the moment it seems like the worst thing possible. Time, however, has a way of changing perspectives on experiences.

This is an unwanted journey and I need to hold on to the faith that I am one step closer to living the life of my dreams.

Normalcy?

The flowers are dead. I tried to pick through them a bit to see if I could salvage the live ones. I am holding on to what? I don't know. I took a small vase from one of them and have decided to make a little dried flower memorial to Sally Ann. Rituals like this feel oddly healing. I used to think that dried flowers were just clutter. Now I feel like I just couldn't throw away these!

Now I am in the phase where I am convinced I killed my baby. Second guessing doesn't even cover it. I started thinking that maybe I shoudn't have induced labor. I had 5 doctors and a specialist telling me to. I just wonder if I held on longer, maybe my fluid would have reaccumulated. Maybe my cervix would have opened slowly enough (it had begun to dilate) that we could have made it to 24 weeks. At that point, I could have taken steroids to help her with her lung capacity. Maybe medical intervention was a mistake. I'll never know because I chose a path on which I could not turn back.

I feel so @*$#% up! I am consumed. The moment I wake up, it's there. I guess I don't want it not to matter. Sally Ann was so important to me- she was my hopes and dreams realized. What kind of mother would I be if I could just brush it off. I just wish it hurt a little bit less.

I want to be in a good place to try again. I want to feel emotionally and physically well so that my body can conceive in October. How am I going to get to that place? How can I find the beauty and goodness in life? How can I find hope?

Breathe in. Breathe out. All I have now is today. Breathe in. Breathe out.

On an upbeat note, someone asked me if I had lost some weight- that I was looking good. Funny what a little blush, a black suit and losing a baby will do for your figure.

I better go attend to my husband. I keep forgetting he is hurting too and needs some attention.

Returning to Work: Easier Said Than Done

I only cried 6 times today. The normal pressures of work, which are great, feel insurmountable. Today seemed like the day that so many people wanted to talk about what happened, to express their concerns and well wishes. It didn't make me feel all that great to discuss it over and over but at least they seem to feel better. Then the vendor that didn't know called and asked if I shouldn't be at home on bed rest still. Boy did that create an awkward moment for the two of us.

Three weeks, three days since I lost my baby. Maybe I am doing better than expected given everything. Trying to make sense of this is a waste of time, but I can't stop wondering why. Second guessing myself is a painful waste of time yet I have made it an obsession.

My back seems worse today. My left leg still hurts and is numb but the right leg felt numb this evening too. I better keep a watch on it. I was referred to a specialist to do some "nerve" studies and for physical therapy. I can't seem to remember to call for the appointment. Is memory loss a common sympton of grief?

Clinical Definitions- Now You Know

Preterm Premature Rupture of Membranes -- PPROM
Your baby is surrounded by a sac of amniotic fluid. Some people call it the bag of waters. In most cases, this sac breaks during labor. Preterm premature rupture of membranes occurs when your water breaks before labor begins and more than three weeks before your due date. You may notice a gush of fluid, a slow leak or a trickle from the vagina. The reason why this happens is not known. There is nothing you could have done to cause or prevent this. Preterm premature rupture of membranes probably occurs for many different reasons. Women who smoke cigarettes, have had bleeding during pregnancy or whose water broke before they went into labor in a previous pregnancy are more likely to have PPROM. Preterm premature rupture of membranes occurs in 2 out of every 100 pregnancies. In cases where the membrane has ruptured very early, less than 20 weeks gestation, you may make the choice to deliver your baby. However, these babies are too young to live on their own.
http://www.mombaby.org/

Oligohydramnios
Oligohydramnios means having too little amniotic fluid in your womb. About 8 per cent of all pregnant women are found to have low amniotic fluid at some point, usually in their third trimester. Among those still pregnant two weeks past their due date, 12 per cent have this condition.
What is amniotic fluid and what does it do?
Amniotic fluid is the liquid that surrounds your baby as she grows in the amniotic sac in your uterus during pregnancy. The fluid, or waters, protects her from being hurt if you have a blow to your tummy or your tummy is compressed. The fluid also plays an important part in protecting your baby against infection and in helping her lungs and digestive system to mature. Babies regularly swallow the amniotic fluid and it is passed out of their bodies as urine. In this way, your baby controls the volume of amniotic fluid around her.

The amount of amniotic fluid you have increases until the beginning of the third trimester and generally peaks at 36/37 weeks, at which point you may have about 800-1000ml/2 pints. After that, it gradually begins to decrease until you give birth. Low levels of amniotic fluid during the first trimester and early part of the second trimester of your pregnancy are rare, but where it does occur, it may lead to an increased chance of miscarriage, or stillbirth.
http://www.babycentre.co.uk

Complications of the above lead to the possibility of:
Pulmonary Hyperplasia- baby's lungs are underdeveloped
Cord Prolapse- restricting oxygen and vital nutrients to baby
Premature Labor
Miscarriage or stillbirth

Always in the background

Just like a cut that is in the process of healing,my pain is always in the background. While I was in the hospital in puerto rico, my lower discs apparently began to compress, causing a numbing pain down the front of my left thigh. My primary doctor wants me to go to physical therapy or consider surgey to correct in the future. I don't feel it at every moment, but it is sort of a dull, numb pain that is pretty much always there. It is just like my thoughts of Sally Ann. I may be cooking, or lying in bed, or reading, or driving, going for walk...and she's there. She's in my mind. My daughter died.

I thought the hardest thing in the world was watching my mother die last year- actually almost a year ago to the day- from lung cancer. It was a slow death. She survived almost 4 years which is a miracle in itself for late stage lung cancer. The final weeks were really hard. I actually watched the body give in and die. I wasn't sure how I was going to get over it. The wound is there still but it does hurt less. The justice in that is that it occurred in the natural order of things- mom dies before child. There is no justice in this. No explaining why.

3 weeks since delivery

I can't believe it has already been 3 weeks since Sally Ann died. I think I may be still in shock. I feel numb a lot of the time. I have been trying to do everything I can to faciliate the healing process. I have been seeing a therapist and went to a SHARE support group last week. I am not usually the support group type, but it was actually a relief to be around other women that were going through experiences similar to mine. I felt like they knew how I was feeling- even though our stories are different, we were bound together by a loss that we could each relate to.

I have a massage scheduled for next weekend and I have been getting out into nature and taking walks in the woods with my dog Lola. I have also been going to Reiki and restarted my acupuncture and herbs to prepare for trying again. The Reiki healer told me a story that brought me so much to tears that I though was going to hyperventilate. As soon as I calmed down, I actually fell right to sleep on the table there.

The shortened story- two little child angels were playing in heaven. They were having sooo much fun, playing here and there, laughing, jumping- they were squealing with joy. Then one angel said the other, "come let's go play over there." and the other said, "no, I need to stay over here." The first angel said, "but we can have so much fun over there." The other angel said,"no I need to stay here. My mommy wants me to stay right here." The moral of the story, of course, let her go and let her spirit be free rather than hold on so tight.

I can never let go of the love I have for Sally Ann. I can never let go of the dreams I had for my life with her. However, Maybe, at some point, I can loosen my grip and take a couple deep breaths. The life I planned will never be and that is just the way it is. But a great life is still inevitable for me. I have learned in this process how much my husband loves me- our bond is much deeper than it was two months ago. I am a mother. Yes my baby died, but I am still her mother and that will also never change. And I believe that I will be a mother to more children. In just over two months I will begin trying again. Only this time, I won't wonder whether I can get pregnant because I know I can.

Post natal visit after "the incindent"

I was at the OB today and he was running late- over an hour- of course he was monitoring someone in labor along with being overbooked.

At first I was ok in the waiting room- I was with my husband and that always helps. Next, a couple of pregnant women came in- and I maintained. I think I stared a little too long, but I kept it together while I nervously looked at my watch every 15seconds.

Next, a woman with her baby came in. Couldn't she shut up? It was like she never had seen a baby before (even though it was hers). She kept coddling and talking baby speak and saying "are you hungry?" and kissing him. I wanted to scream at her!

My husband tried to keep me calm as tears starting streaming down my face. Then he tried to get me to laugh, which worked, but now I am laughing and crying and the woman has noticed- she is looking at me like I might have some mental status issues. Finally, 30 minutes into the wait, the nurse asks if we might be more comfortable in a private room to wait. I would be more comfortable with a poker in my eye.

On a positive note, I have now lost 12.5 pounds in 3 weeks.

The autopsy results came in- Sally Ann was in perfect shape- no abnormalities, in the 75th percentile- the only thing notable was her middle toe was longer that her big toe. The placenta was perfectly fine too. The only thing they can point to for my water to have broken was the bleeding I had had during the past 2 months. In fact, continued bed rest might have saved this pregnancy. If it were 6 weeks later, we would have been talking about a viable pregnancy, although I know the complications and risks may be great with a very young preemie.

Hindsight is everything I am told. Next time around, I will wrap myself with saran wrap and stay in bed for 9 months. I need to NOT focus on this. Many women bleed during pregnancy and don't lose their baby. Many women walk around and don't lose their baby. I tripped and fell the day before. Not hard though. Many women trip and fall and don't lose their baby. I am telling myself there was nothing more I could have done.

What If's

I was feeling relaxed and even hopeful tonight until I went to kiss Sally's urn. My husband and I got to talking about the what ifs. What if I didn't go to puerto rico? What if I didn't trip and fall? Would I be where I am now? Would Sally Ann still be alive? I have to assume no since I did so so much for this. I REALLY took it easy. I did everything they told me to do.

I guess there can be no second guessing. The experience was amazing- it was like nothing I ever had before. Thank you Sally Ann. Thank you Lord.

Early in the Pregnancy

Thinking back to the pregnancy, the next week or so after the good news included repeated trips to the hospital to retake the pregnancy test and to make sure I was really pregnant. Each time was filled with trepidation followed with such hope, then happiness, then relief.

Was this really MY time? My baby?

I was so happy and terrified at the same time.

I am so in despair at what happened. I wanted Sally Ann so badly and now she's gone. Not even a chance to take her first breath. It feels so unfair. How do I find hope again to go on? How do I find relief? I can't make sense of this nighmare. I wish I could wake up and it all will be gone!

I feel sad

I just finished reading empty cradle, broken heart and I feel heartbroken. I know I will get through this but part of me almost doesn't want to. Part of me fantasizes that I will wake up and this will all be a dream. The book made me realize that I am not alone and if all those people got through it, I will too. One day. I love you, Sally Ann.

At last!

Let me digress...I will never forget the moment I found out I was pregnant. There had been a misunderstanding as to when I was supposed to have the pregnancy test. I could have sworn that the nurse told me Sunday. I clearly remember that was hard since I was on vacation, visiting my dad in NY and I wasn't sure where to go on a Sunday for this test. I ended up waiting until Monday and going to a local hospital.

As it turns out, I was supposed to wait until Wednesday. My fertility nurse called me later that day to let me know it was too early, that the test would not be accurate this early and to retake it on Wednesday. I would be back home by then so I would go to a different hospital near my work.

So there I was on Wednesday morning, waiting for the attendant to enter in all the information into the computer, waiting for the needle prick that could change my life- I was so nervous I was sweating- and my phone rang. No cell phones in the office- but I looked down and it was the fertility nurse.

I excused myself for a moment and left the office to take the call. "I don't want to gets your hopes up, but the test you took the other day came back positive." Tears streamed down my face.

Pregnant.

I was pregnant.

It was a sentence I had longed to hear for 3 years.

The email after the loss

It is with much sadness that I report in my latest update. Last Saturday, I prematurely delivered our daughter at 19 weeks gestation. Sally Ann died in childbirth.

My water broke while we were in Puerto Rico almost three weeks ago. We attempted to save the pregnancy by my going on total bed rest at a local hospital. My insurance company spared no expense to hire a private medical Learjet/air ambulance to get me back to a Massachusetts hospital (I hear it cost 50K), but there was little anyone could do but hope that the fluid would re-accumulate. It did not.

I was in labor for 22 hours. Sally was born on July 26, 2008 at 11:09 am, weighing just 7 oz and was 9 inches long. She was beautiful- fully formed with fingernails, big feet (like dad) and cute little ears.

The greatest gift that Sally gave me was renewed hope that I can and will be a mother.

The Final Days

Over the next couple of days, I had the opportunity to speak with many doctors, including my own. In fact, consulted with three OB's and one perinatologist with a lot of experience with pprom (preterm premature rupture of membranes). Their biggest concern was that I would get an infection that could come on quickly and cause me to get sepsis, lose my reproductive organs, or worse.

"The risk did not outweigh the benefit" was the recurring theme of their opinion. If I did not get an infection and we continued with the pregnancy, I would still most likey go into labor. If that did not happen, the baby would be born with pulmonary hyperplasia- underdeveloped lungs and could die at birth or shortly thereafter. The cord could become prolapsed without the fluid needed to protect it and then oxygen would not get to the brain, causing brain damage or death. Plus, muscle development would be curtailed since the uterus was literally closing in on baby. She could make it- no one would say it was impossible, but it would have to be a miracle. I felt that the pregnancy in itself was a miracle and I was almost willing to take that risk. She was, after all, my baby. As a mother, I would do anything to protect her. I love her more than life itself.

I was heartbroken. My husband and family were only worried about me at this point. The risk to me and my future children was too great. What if I went on and I lost my reproductive organs and we lost the baby too? Then how would I feel? What if I died? They needed me to be ok first.

On Friday, I asked for one more ultrasound. As I was wheeled down on the stretcher to radiology, I prayed for a miracle. I guess it wasn't my time for one. There was no fluid at all and the tech noted that the baby looked more like 10 weeks due to the fact that my uterus was pretty much crushing her.

I consented to induce labor at 2:00 pm and we began the process at 3:00 pm. When the doctor placed the pills in my cervix to begin labor, he noted that my cervix was already 2 cm dilated- my body had already begun the process and labor would have occured anyway.

I was in labor for over 22 hours. At 11:09 am, she literally popped out. At 1:30 pm, the placenta followed.

Doug and I had a chance to hold Sally Ann and cry for the loss of the family that wasn't. They dressed her in a cute little pink cover. I kissed her. She was cold. She had died at some point in the labor process. They gave us foot prints and hand prints ss our consolation prize. This was supposed to be a happy occasion. I wish the memories of my baby were happy, but nothing can take away the fact that she was MY baby.

The Great Escape

I called my case worker on Sunday afternoon and left a message explaining what I needed. I didn't wait for her to call me back on Monday morning- I called at just after 9 am. I had to convince my HMO that, while although bed rest was the only treatment for my condition, I HAD to do bed rest in the US and they should fly me home no matter what the expense. My husband had called around and found some local companies that could do it for about 30K. So much for paying out of pocket if we were denied. Even my dad said he would help but was shocked at the sticker price. The doctor in san juan said it would make better sense to save the money for IVF than to blow it on this. He had given up on my baby, whose heart was still beating just fine.

All the doctors and I were calling in with the info, faxing the details, I was pleading and crying with the HMO. Only now do I hear that, if an infection occurs, I could lose my ability to reproduce, or I could get sepsis. Maybe I heard it before, but it didn't register until now. After waiting most of the day, the decision came back- NO. They wouldn't pay for it. If I didn't agree with the findings, I could appeal the decision but usually it takes a while to get the answer back from appeals.

I was distraught. I worked on the appeals with all the doctors and a new case worker from the HMO who was so caring and sweet. In the meantime, my OB from the states called the medical director that had made the initial finding. I don't know what he said or how he said it, but the HMO reopened the case- that never happens I am told. Usually a decision is final and the chance for change is in the appeal. Nonetheless, there was to be a meeting about me on Tuesday at 12:30 pm. Ok- I wasn't going home on Monday. I could make it one more day.

My husband and I decided we were getting out of dodge one way or another. If I had not reaccumulated more fluid on Tuesday am and if there was no dice on the air ambulance, I would take the one direct first class flight out of there, leaving at 6:30 pm. We would arrange an ambulance to the airport and then use wheelchairs until the flight. We arranged for me to be admitted into the hospital Tuesday night one way or the other.

On Tuesday afternoon, we were completely packed and waiting. It was getting late and we were going to need a decision or we would need to leave for the airport. We could continue to wait there if we needed to. The call came in- they granted me the air ambulance. I was so happy for my baby!

It was a private, lear jet that would fly to about 15 miles away from the hospital. Let me be clear, this was not a luxury lear jet but it definitely was what I needed if Sally Ann even could have a chance. The jet was just big enough for me, my husband, two medical personnel and two pilots. No cocktails. No rest room. Sitting room only- it was too small for an adult to stand. That was fine for me- I was on a stretcher. The nurse on the flight told me of an insurance one can buy if travelling that will automatically pay for something like this- called Med Jet Assist ( http://www.medjetassist.com ). I definitely will get this when I travel in the future.

We arrived into the hosptital at about 5:30 am on Wednesday morning after the plane had to stop twice to refuel. My OB was there waiting for us. It was so good to be home. I knew nothing had changed with Sally Ann and her chances of survival, but at least I was with people I knew and I could understand them when they spoke to me. The ultrasound revealed status quo- no fluid, but a healthy heartbeat and movement. All I could do now is to keep praying.

The nightmare continues

The doctors were good in puerto rico. I felt like they really cared and did know what they were talking about. They obviously were worried about what I thought. They would list off their training, where they went to medical school, etc.

The nurses. That was a little different. Pretty much no one spoke English. That made it difficult since we didn't speak Spanish. They apparently didn't get the blood borne pathogen memo since they were putting in IV ports and taking blood from me with no gloves and not washing their hands. At one point, my blood was getting on a nurse's hand and she wiped it off and finshed putting in the port. No handwashing after that. Hmmm. If she isn't worried about getting my cooties on her, what sort of cooties is she bringing into the room? But wait. There's more...

Nurses were helping me wipe my bowel movements (remember I am on total bed rest here) without wearing gloves and without washing up afterwards. In the meantime, I would wait up to 45 minutes on a soiled bed pan to get nursing help. This is ridiculous! Hubby began taking over bed pan duty. Let me say- I am the kind of girl that still closes the bathroom door when I pee. Now my husband is measuring how much pee is in the bed pan and helping me wipe feces off my butt. I always knew how much my hubby loved me. Now I KNOW in a way that is indescribable. I love him with all my being. I am so lucky he is here, by my side, taking care of me.

Back to the standards of care. They would often forget to change my IV or give me my medication so my husband had to be in charge of that too. The icing on the cake would be the daily baths. I was happy to have them, but the nurses would want to put me on the bare, stained mattress to clean me. Every time, it was a nightmare that would end in tears. I was convinced I was going to get some sort of virus or communicable disease here. I welcomed every temperature check to ensure I didn't have a fever. That meant I was still ok. And baby- she kept on just fine too. Heart beat good, movement. She was a fighter. I heard several times that girls are stronger than boys. No big surprise there, but it was nice to hear.

On Sunday morning, the doctor came in to see me. He was going on vacation the next week and wanted to discuss a possibility. Since my fluid had not reaccumulated, maybe I should consider getting back to the states now. If the fluid did reaccumulate, I would need to stay here until the birth. Just talking about the possibility of my baby surving made me feel good. Getting out of dodge? That was a good idea too. My health insurance company was closed but I would call them on Monday morning. I had discovered during the week that I had "air ambulance" coverage and my thoughts were that now would be a good time to collect on that.

A hospital from nowhere

I was admitted into the hospital. Nothing was happening tonight. The nurse told me to let her know if I stated to go into labor. The doctor said it could happen at any moment. This was not good news. My husband and I got a private room and paid for a cot for him to sleep on. The room was old and very small. It wasn't dirty per say- just old. I kept reminding myself of the hospitals my mom was in. Her rooms were bigger, but pretty much like this one- old.

Every additional thing is on a cash-only, a la carte system. You have to pay in cash daily for a cot, tv access, even pillows and blankets. They didn't even give us a towel for the room. Since it was so late at night, they couldn't give me any pillows or blankets- that department was closed apparently. Hubby went to a nearby walgreens and bought me a blanket. They had one in the whole store. I guess it was meant for me. I used my clothes as a pillow.

The next morning, the doctor came to see me. The ultrasound looked the same. No fluid and baby was doing well. No labor. That was good. He told me that in some instances, though rare, the fluid does reaccumulate and so just to stay put on bed rest and see what happens.

That was the status quo for the next week. On day three my body had miraculoisly started reaccumulating fluid- a miracle baby and she was mine! Two days later, the fluid leaked out and we were back to square one. In the meantime, I was speaking with my OB's office daily and they were telling me the same thing- the fluid could come back, and that was my only hope, so stay on bed rest. It was easy for them to say. They weren't in a community hospital in puerto rico.

The day the earth stood still

I will never forget the feeling. I was lying in bed reading and it was about 10 pm on a Monday night. My husband and I were on puerto rico- our 5 year wedding anniversary trip. Our baby moon as it is called. Sally Ann was 17 weeks gestation. I had just finished watching a BBC pregnancy calender DVD that shows what is developing at what time frame. I had found out recently that my baby's hearing was developed and that she could recognize her mom's voice. I was talking to her a lot in the days before. How cool! She could hear me and I could tell her how much I love her.

That feeling. It was like I was peeing all of a sudden. Drip, drip drip. It felt so weird. I couldnt stop it. I went to the bathroom to see what was up and wooosh! Fluid started coming out of me. This is not normal- I knew that. I was panicked. I woke up my husband. He didn't seem too concerned. I called my OB back in the states-the doctor on call called me back quickly. She remained calm and wanted me to do so too. She suggested I relax, stay in bed and go see an OB in the morning.

I was extremely scared. I was wearing a pad and it was drenched in a sort of watery fluid with a distinctive smell. I can't really describe it. It wasn't a bad odor, just something I had never smelled before.

We got to the hospital the next morning at 8:30 am. The concerierge highly recommended this hospital about 10 minutes from the hotel. We signed in- first I wrote on the sign-in paper that I was 37 weeks and water broke. Then I realized what I wrote and changed it to 17 weeks. The happiness of the staff turned to concern. They brought me to a bed and I waited. I waited all day. They took blood, hooked up an IV, took a urine sample. Gave me an ultrasound. No one was saying anything- we just waited. My husband and I talked about dinner. I hadn't eaten anything all day and was starving. We decided that, after this scare, we were NOT having the amnio. We would take what we got and that's that.

This was too much for me to handle. At week 9 I had a blood clot. In the middle of the night, I awoke to a mass of tissue coming out into the toilet. I thought for sure that it was baby. We went to the OB in the morning and baby was just fine but I had developed a blood clot in my uterus that remained there, though getting smaller since then. Every couple weeks I would have a massive bleed, followed by occasional spotting. I was on modified bed rest off and on for weeks 9 through 16. I had gotten the ok to come back to work and the ok to go to puerto rico. I had no bleeding for 3 weeks prior to the trip. Doesn't do me any good now. I wondered if the two might be related.

The doctor finally came in at about 4:30 pm to talk. He brought us to a labor and delivery room. This scared the heck out of me. Why was I in this room? He proceeded to tell me that my water broke, as I had suspected, and that there was pretty much no amniotic fluid left in me. He said that I would most likely go into labor in the next 48 hours but I could help the process along if I liked. Was he out of his mind? I couldn't understand what he was saying to me. I think he was saying I should terminate the pregnancy. Yes- that is what he was saying. At 17 weeks gestation, the pregnancy was not viable and would still be considered an abortion. The baby, on the other hand, was doing well- the ultrasound showed a normal heartbeat and movement.

I thought was going to pass out. What were my OTHER options? Well- the doctor mentioned that I could get an infection since my cervix would be opening. That would be bad. I asked if I could possibly have IV antibiotics. The doctor thought that would be ok. I was confused, scared and inconsolable. Then I started bleeding. Damn this! This was my baby. This can't be happening to me. Please! Tell me this isn't happening!

The beginning of my story

The minute details of this chapter of the story is yet to be written...I can't deal with that part right now.
For now, here are the stats. I am 40 years old. I began trying to get pregnant 3.5 years ago, age 36. I got married to the man of my dreams when I was 35 and we decided to wait a year before beginning our family. However, once we started, it became obvious this wasn't as easy as I thought it would be. A drunken night of passion didn't do the trick. Neither did 6 months of tracking my basal body temp (BBT) and using ovulation predictor tests. Since time was a wasting, I decided to call in the big guns. Our next steps:
7 Clomid IUI- BFN
1 cancelled IVF (due to poor response) converted to an IUI- BFN
1 IVF- 5 eggs retrieved, 4 embryos viable- used two, froze two. BFN
1 frozen cycle IVF- BFN
Moved to another state. New insurance coverage kicked in after 4 months, took another 2 months for insurance review- they denied IVF without another 2 IUIs- this time with injectibles (FSH)
FSH IUI number 1- successful! who would have thunk it?
This is why it seems so unfair that I would lose this baby. This was a baby that was dreamed of and desired for so long.