Thursday, March 8, 2018

Katherine Belle Stubblefield, Part #2

"Healing does not mean going back to the way things were before, but rather allowing what is now to move us closer to God." -Ram Dass

Something that I found terrifying happened the Monday after my D&E.  David had to go back to work.  I knew he couldn't stay out forever, but still, I was so terrified of being alone with the kids.  It seemed like those were the times that I couldn't think about anything but Katie.

The first day he went back went surprisingly smooth.  He was going to get off early to go to an appointment at the eye doctor and we were going to meet him there, just to have something to do.  As odd as it was, I looked forward to that.  Things just felt better when we were together as a family.

The next day, however, sucked.  I woke up, got dressed, went to the kitchen, and cried for probably an hour while the kids played in the den.  I knew it wasn't good for them, but I literally felt powerless to stop it.  I'd get them whatever they needed in terms of food and things like that, then go back to crying.  I was just going through motions.  I didn't even attempt to do any school with Joseph.  It was a bad day.  David called to check on me and when he saw how poorly I was doing, he came home a little  early to be with me.  We talked, I cried, and we took the kids to a park to give them a diversion.  The next morning, I woke up, he went to work, I got dressed, went to the kitchen, and cried for another hour.  Same story, different day.  I knew the kids couldn't possibly understand all of this and, as much as I shouldn't be expected to hide my grief (no loss mom should be expected to), I also knew I had to do a better job of at least functioning for Joseph and Elisabeth.  I was scheduled later that morning to go to my doctor's office to have my blood work done to check me for infections that may have killed Katie.  I wasn't supposed to see my doctor while there, my post-op appointment wasn't scheduled until about 2 weeks later.  I was just to see the lab ladies.  Somehow I got myself and the kids together and went to the appointment.  The longer I sat in the waiting room the more I struggled to keep it together.  The more pregnant women I saw, the worse things got.  By the time nurse Gay opened the door to get me, I had started crying.  When she hugged me, I really lost it.  "Let's just get you to see him for a minute while you're here today." ("Him" being Dr. Lowe) she said.  I told her no, that I knew he had other patients and he needed to focus on them.  And she just kept saying "No, he'll want to see you."

I guess maybe someone went to get him, because we walked down the hallway immediately and, when I turned the corner, he was standing there waiting on me.  Jojo and Lizzie were right behind me.  Joseph asked him right away "Dr. Lowe, is Katie really gone?"  Dr. Lowe just looked straight ahead at him and said "Lisa, what are we saying about this?"  I just said "Joseph knows the whole story, you can say whatever you want."  He took us to his office and closed the door.  He asked how I was eating.  Not well.  He asked how I was sleeping.  Nope, not well, either.  I told him I was standing in the kitchen each morning and crying and basically just barely taking care of my family's basic needs.  He told me these were all symptoms of PTSD, which is super common after miscarriage (also common after infertility), particularly a later miscarriage like we had with Katie.  I told him I felt like I was barely functioning and he said he wouldn't expect me to be doing any better than I was.  I told him it was a less than a week before Christmas and I didn't know how I'd be able to do holiday stuff.  So we started talking about antidepressants.  Those who know me know I don't like taking meds I don't need.  But honestly, in the spirit of vulnerability, I needed something.  I knew I did.  If nothing else, for Joseph and Lizzie.  Since I was (and still am) nursing Lizzie it needed to be something safe for breastfeeding and also something safe for pregnancy should we get pregnant again.  I told him right then that we wanted to try again and he totally agreed.  He was so encouraging about it.  He wrote me a prescription for the lowest dose of Zoloft.  He told me if the lowest dose wasn't effective to call him and we'd do more.  And he told me to stay on it as long as I needed.  So I went straight from the office to CVS and picked it up, and started on it that night.  And I don't regret it, looking back, even one little bit.

For several days I noticed no difference, which was discouraging.  I was still crying a lot, still felt like I was just barely going through the motions.  Then, two days before Christmas, I decided to start taking it in the morning, instead of at night, as I had been.  And the difference was amazing.  Did it magically make everything okay?  Well of course not, nor was I looking for that.  But, for the first time in almost 2 weeks, I was able to get some perspective.  Did the whole thing still totally suck?  Yes.  But did I feel like there may still be hope for the future?  Yes!  I started to gain perspective that God DID still have a wonderful plan for us after all.  On Christmas eve, as I ran around the house cooking and cleaning for our guests that were coming the next day, I told David "For the first time since she died, I feel hopeful!"  I even found myself singing a Christmas song while I was cleaning, less than two weeks out from the darkest day of my life.  I was amazed.

Christmas Day was really lovely.  I still couldn't believe what had happened, but dare I say, I felt some happiness.  I had two beautiful living children, an amazing husband, and a house full of people there to celebrate the birth of Christ and overfill on delicious food.  It was a good day.  It felt like Christmas, more than I thought it would.  We had also decided the next day to go to Myrtle Beach for 4 days.  That is not our typical post-Christmas tradition, but we decided a few days away as a nuclear family may help start the healing process.  So there was that to look forward to.  We ate ,visited with family, opened gifts, and my eyes were opened to the thought that 2018 may be a year of hope for our family, despite the past.

Christmas Day 2017

Christmas Day 2017

The next morning we got up and headed out for North Myrtle Beach, just the four of us.  Going into it I truthfully didn't have high expectations for this trip.  How could I be happy at the beach just weeks after what had happened?  And to make matters worse, the weather forecast wasn't looking good.  It was going to be unseasonably cold, even ICY, at the beach.    We were not sure how much would be opened in the off season.  We didn't even know if we'd find anything to do, aside from enjoying the indoor pool and hot tub in the same hotel we always stay in in the summer.  But off we went.  And it ended up being amazing.  The day after we got there we woke up and took the kids to Ripley's Aquarium.  While we were walking around I remember thinking "Wow, I actually feel kind of happy!"  It was such a sweet family time.  We talked about Katie, but we also talked about many other things.  Her death was not all-consuming while we were there.  I also ate - a lot.  And began the process of gaining back all that weight I'd lost (although I'm still not certain if that's a good thing or not, lol).  We ate out every.single.meal - breakfast, lunch, and dinner - for 5 days.  And any other time I'd probably be horrified by that, but I have to say in this case it was amazing.  It was ridiculously cold, even for the winter, at Myrtle Beach.  It was 19 degrees one morning, and the bushes outside our hotel had ice on them.  Several of the places we wanted to go while there were closed for the off-season.  But we made the best of it all.  It ended up being a very healing few days.

We were right around this area in the aquarium when I saw how much fun the kids were having and I realized that I, myself, was starting to be able to feel something other than sadness.  <3 nbsp="" td="">

Cold weather, but we were not discouraged

Even Joseph enjoyed the hot tub, which he called a "warm tub" because "It's not THAT hot."  

WonderWorks at Broadway at the Beach

We returned on December 30th.  The next night, things hit me hard again on New Year's Eve.  I went to bed right after midnight, after watching the ball drop, realizing that 2018 was supposed to be the year we brought home a new baby, and we wouldn't be doing that.  I cried myself to sleep.  Then I got up the next morning, determined to make 2018 "our year" one way or another.

On January 4th I had my post-op appointment with Dr. Lowe.  I came loaded with questions.  A LOT of questions.  I had always written off all of our losses as unfortunate coincidences, but I just couldn't do that anymore.  I felt like there must be some issue we were missing.  Dr. Lowe probably sat with me 45 minutes while we discussed ideas, things we could test for.  Finally, he told me he was going to call a well-known reproductive endocrinologist in town, a man known for his ability to figure out recurrent pregnancy loss, and get his thoughts as to a comprehensive list of things to test for.  He also told me the wanted me to wait 2 cycles to start trying again, to give my body time to totally heal.

48 hours later, a nurse called me and told me I could come pick up my testing orders and take them to LabCorp to have my blood work done (since David works for LabCorp we get all lab testing free, thus we try to always use them when possible).  I made an appointment the next day at the LabCorp patient service center and went to have blood drawn.  And draw blood, they did!  13 tubes of it!  It was so much that the phlebotomist left the room to confirm my lab orders and make sure that was correct.  She was shocked at how much she was going to be drawing (although it's still less than I give at the Red Cross, so I didn't think it was a big deal).  I felt good about the fact that this testing was going to be extensive.

In the meantime I also got my results from my prior blood work and from Katie's chromosomal analysis.  I had no infection, and Katie was chromosomally normal.  She, and I, appeared to be perfectly healthy, until something happened.  So that was it, this extensive blood work would be our last opportunity to figure out why things kept going wrong.  I was absolutely terrified of it all coming back normal, and of there being no answers at all.

A little over a week later, results were back.  I saw them on the LabCorp patient portal first, but I didn't know what to make of some of them.  But Dr. Lowe called me that morning.  Two things were revealed...

1) I am heterozygous for MTHFR c667t, which is a relatively common genetic mutation.  Normal people carry no "bad" copy of this gene, then for those that do there is the possibility of carrying one copy or two.  Obviously, two is worse, and I only carry one, so that's one small piece of positive news.  But ideally you don't want to carry any bad copies of this.  Now, how this plays into pregnancy loss gets tricky.  Basically, the medical evidence over the role that the c667t mutation plays in pregnancy loss is quite conflicting.  Some studies have shown significance (as in it does tend to lead to additional blood clotting, causes an inability for those affected to properly process folic acid, and also an inability to rid the body of toxins properly) , yet others have shown no real link.  Thus, most mainstream medical providers do not believe it to be significant in the occurrence of recurrent pregnancy loss.  My doctor is included in this and, although he and I disagree on this point, it doesn't worry me because MTHFR is something that I can manage by myself through proper diet and by limiting my exposure to toxins as much as possible (we have moved from eating organic fruits and vegetables to an entirely organic diet and have also become extremely picky about what products we allow in our home in general in terms of toiletries, cleaning products, etc etc).  So, while I personally do feel like MTHFR has played a role, it's something I can manage on my own.  My OB does want to keep a check on my homocysteine levels (which often run outside of normal range in MTHFR) for my own health, so that's also a good thing.  So, MTHFR, while an important finding in terms of my overall health and potentially in terms of our pregnancy history, is the less important of the two things discovered in this blood work.

2) I was found to be homozygous for the PAI-1 4G/4G polymorphism.  Never heard of it?  No worries, you and 99.99999999999999% of people in the world have not heard of it.  Very few physicians I'm finding are even familiar with it, outside of hematologists, cardiologists, and OB/GYN who have experience with testing for and treating recurrent pregnancy loss.  I'm tend to be a researcher and have spent hours doing research on this factor and the information that exists on it is pretty limited, worldwide.  From my understanding, this polymorphism was not even discovered until some time in the 1990s.  PAI-1 stands for Plasminogen Activator Inhibitor-1.  Normal individuals are PAI-1 5G/5G.  Then there is a somewhat common variant of the trait called PAI-1 4G/5G.  Then there is the 4G/4G version, which is quite rare and the most severe form.  What this means is, when a normal (5G/5G) person's body produces a blood clot, their body has a mechanism that keeps the clot at a healthy level and helps dissolve it if it starts becoming problematic.  In individuals that are 4G/5G, their body does a less successful job at breaking down clots.  And in a 4G/4G individual, like myself, the body does a really, really, really crappy job at breaking down clots.  It is quite heavily linked with infertility (and of course my endometriosis and MTHFR is linked to that as well) and recurrent pregnancy loss.  If my body produces any clotting in the placenta or umbilical cord during pregnancy, my body lacks the mechanism to easily dissolve that, thus cutting off circulation to the baby.  It is also linked to IVF implantation failures (hence, the loss of our four adopted embryos), and some anecdotal evidence has even linked it to 3rd trimester losses and cases of fetal distress.  So, part of me now wonders if marginal cord insertion was really the cause of Joseph's sudden distress at 37 weeks, or if it could have been this.  Or both.  I have no idea, really.  Whether or not this was the sure cause of death of Katie or any of our babies, we can never prove.  But it does seem to be the linking factor in most of it.  This mutation can also have a very high impact on my own health.  It is linked to a substantially increased risk of deep vein thrombosis, heart attack, and other cardiovascular events.  There are also pretty conclusive links being explored between this polymorphism and diabetes, morbid obesity (needless to say I've started watching what I eat even more), increased susceptibility to viral infections, and poorer outcomes after health problems, among other things.

SO, where do we got with all of this?  Well, lots of places.  Like I said, I am managing MTHFR on my own.  I've never been more conscientious about what I'm putting in and around my body.  I've switched to a prenatal vitamin with folate instead of folic acid, which is the form generally absorbed by those with MTHFR.  I've also switched my other supplements to methylated brands which are easier for MTHFR individuals to process.  In terms of PAI-1, my OB will have me starting twice-daily Heparin shots the moment we get pregnant again.  As I stated in yesterday's post, we actually got pregnant this past month (apparently I do have some fertility in me after all!) but were not able to get Heparin started quickly enough and, within 48 hours of the original positive test, I was already in the process of miscarriage.  Thus, my OB has now called Heparin in for me to keep here at home, so that I can start it immediately next time and we can hopefully get ahead of this issue.  Heparin is a blood thinner that will keep my clotting in check during pregnancy.  Since PAI-1 can also affect my overall health, I've taken a very intense focus now on cardiovascular health especially.  And I'm heavily concentrating my efforts on detoxing my body and lowering my underlying inflammation, which is also a factor in all of this.  I'm learning more every day, and I feel more empowered than ever to take healthy steps for myself and for future babies.

Last but so far from least, I have to spend some time talking about the things our friends did for us during this challenging time.  I can't even being to outline it all.  People brought us dinners.  People sent us flowers.  The amazing mommies from our play group made me an incredible gift basket, filled with items not only to help us to remember Katie but also just to bring comfort to myself, David, and the kids.  Another friend had a memory box made for Katie for me to keep all of these treasures in.  I just can't express how loved we felt.  I could go on and on, but it would never be enough to say thank you.  It makes me feel like we weren't the only ones that loved Katie.  So many people have been instruments of God's love for us during all of this.

My dear friend Jessica had this Christmas ornament made for Katie, along with this sweet note.  I treasure both.  

This memory box from my sweet friend Meredith currently holds every tangible thing ever associated with Katie - all the ultrasound photos, all the cards we received, things from the day of my surgery.  I'm so grateful for a safe place to keep them all.

So, where are we now?  I can say that I'm constantly surprised by God's grace.  His mercies really are new every morning.  Some days I float through the day easily, occasionally reflecting on the life of Katie and of all of the babies we've lost, but also praising Him for the two living children He's given us in between all of the challenges of growing our family.  Other days I still feel could I have a 20% success rate at taking a baby from embryo to healthy newborn and possibly think that we'd be able to do it again?  How can I reconcile that we were allowed so many weeks with Katie and so much time to love her, only to have her taken suddenly?  How will I possibly survive the anxiety I'll feel if we're able to get pregnant again?  What if we can't get pregnant again?  I even have days when I fear the adoption process awaiting us one day.  What if that process is not straightforward, either?  It always feel like building our family is a struggle.  Yet, whenever I have these thoughts, somehow He always allows me to wake up the next morning with a hope for the future, and an anticipation of things to come.  One of my biggest fears was that this experience would always taint my view of Christmas.  I think I remember mumbling something to David in Dr. Lowe's office that horrible day, something along the lines of "How could this happen two weeks before Christmas?!  Now my view of Christmas is ruined forever!"  But it hasn't been the case.  If anything, it has deepened my thoughts on Christmas.  Because that's why Jesus that this world wouldn't be all there was.  So that one day, as much as my arms feel empty of 8 babies gone too soon, I'll be able to hug them and love them for eternity.  One day. 

For now, we continue trying to get pregnant, seeing what each month brings.  We have set firm parameters around how long we'll try to have another child through pregnancy.  I'll be 37 in May, and we can't go on forever.  But I've shared those parameters with only a very few people.  It's been a personal decision between David and myself, and I think we both feel good about it.  But right now I'll just say, there's still time.  And maybe it won't ever happen, and that will be our answer.  But maybe it will.  And either way, we feel so much excitement about the adoption journey ahead of us in the future.   I've been off of the Zoloft now for an entire month, and I feel like it did it's helped me gain some perspective, and now I no longer need it.  Joseph seems to have processed Katie's death well...he still talks about her and asks about her, but he sees that mommy and daddy are okay, so he can be okay, too.  Lizzie is blissfully ignorant of it all right now, but we'll always make all her siblings a real part of her life and of our conversations, just like we've always done with Joseph.  Our family is healing.  God is so, so good.

If you are a woman walking through infertility.  Or your first loss.  Or your 10th.  PLEASE, I beg of you, don't be afraid to grieve.  Don't be afraid to talk about it.  Don't be afraid to do what you need to do for yourself - be that reaching out to a friend, avoiding a baby shower, taking an antidepressant.  You are not alone.  I see you.  None of this is your fault.  This is why Jesus died for us, so that there would be something more.  You are so brave, and you are an amazing mom, whether your children live or not.  <3 br="" nbsp="">

Thanks for reading Katie's story.

Wednesday, March 7, 2018

Katherine Belle Stubblefield, Part #1

"And sometimes, when the cry is intense, there emerges a radiance which elsewhere seldom appears: a glow of courage, of love, of insight, of selflessness, of faith.  In that radiance we see best what humanity was meant to be...In the valley of suffering, despair and bitterness are brewed.  But there also character is made.  The valley of suffering is the vale of soul-making." -Jerry Sittser

I haven't blogged in a while.  And some of it is just that, as usual for me, my blogging is behind.  But another part of it is that I wouldn't feel right going back to blogging without the first post being about our sweet little Katie, and maybe I just wasn't ready, until now.

Everyone knows I've always been completely and 100% open about our journey through infertility and multiple miscarriages.  And I do this for no other reason that I hope to break the taboos around this subject.  I don't want women walking these roads to feel alone, or to feel like no one understands.  I don't want people experiencing these things to be ashamed to say "This is what's happened to me, and it was real, and it hurt me so badly."  Because how can we support each other if we don't know?  And what I do know is that sometimes it's all too easy to hide these things, and to try to deal with them privately.  For many women, that way of coping is simply not helpful, or healthy, and I've always felt like if I share our story, maybe other women will, too.  No one should have to hide their grief from the struggles to get pregnant, or to stay that way.

Most of you who have known me for a while have known our story.  5 cumulative years of infertility.  The loss of 8 babies to miscarriage starting after Joseph's birth - 2 losses of biological babies, followed by the loss of 4 babies that we adopted as embryos, followed by the loss of two more biological children (Katie and one other baby that we have lost since in a very very early loss).  Eight pieces of my heart - four that share my DNA and four that do not - that I'll never know on this side of eternity.  So what makes Katie's story different?  Nothing, really, in the grand scheme of things.  Her siblings that were lost were, in my worldview, every bit as human, every bit as real, and certainly every bit as loved.  But, in another sense, Katie's loss WAS different.  She was the first baby that I lost in the second, not first, trimester.  She was the first in which we had gotten far enough to know her gender, and to name her BEFORE we lost her (we've named all of the babies we've lost - it has always been part of the healing process for me - but the others were named AFTER we had lost them).  In many ways, it felt like we "knew" Katie more than the others, as she had been with us longer.  So losing her was the same, but different, if that makes any sense at all.

When I was pregnant with Lizzie, after the incredibly long struggle it had been to have our second living, breathing baby, we had both said she would be our last pregnancy.  We have had, and still have, adoption on our heart, and thus we had planned to continue building our family through that method after she was born (and as a note here, that's still part of our plan in the future...nothing has changed that).  But after she was born it only took a week for David and I both to start musing that maybe we'd want to do pregnancy "one more time."  We started trying basically right away (around the time Lizzie was 9 weeks old), which probably sounds crazy, but when you have my history of infertility there is never any time to waste.  

I was oddly different in the journey to get pregnant again.  I no longer felt the desperation that infertility had left me with in the past but instead felt peace that whatever happened, happened.  If I got pregnant again I decided that would be an enormous blessing, but if we didn't, we were planning to adopt anyway.  And, seeing as how we've really always desired four children, we figured an inability to get pregnant again would be God's way of leading us to adopt two children from foster care instead of one.  So, for me, the entire prospect seemed like a win-win.  11 months passed with negative pregnancy tests, and, instead of locking myself in the bathroom and crying each time, as had always been my custom when trying for Joseph and Elisabeth, each month I found myself just rolling my eyes, joking that it was "typical" for us, and tossing the negative test in the trash.

Suddenly, September was upon us.  Lizzie was 14 months old, we were on our 12th month of trying, and I was still feeling peace about the fact that we had not gotten pregnant.  On the morning of Wednesday, September 27th I took a test and it was negative.  Not surprised, I tossed it and went about my day.  But, that afternoon, something told me to test again.  I can't explain it, or why I thought it would be any different.  I'd always gotten positive tests by that point in other pregnancies, so I figured I was out for a month.  But I grabbed a test from my stash (infertile women ALWAYS have a huge stash of pregnancy tests ;-) ) and, lo and behold, I saw a faint second line appear almost immediately.  

I was at once surprised, excited, and terrified.  Even though our last pregnancy had ended in a healthy baby girl, our history of loss always haunts me, especially in those early days of pregnancy.  In the first few weeks after any positive pregnancy test I'm always expecting to miscarry at any minute, which is a terrible way to be, but experience hasn't been good to my sense of optimism in the first trimester.  Joseph has been doing Awana at church this year on Wednesdays and I have been volunteering as one of the leaders in his group.  This was just our third week of Awana and David was going to be rushing home and grabbing Lizzie while Joseph and I ran out the door.  He was supposed to be stopping on the way to get Chick-fil-a for him and for her, but I called him and said "I think you better come directly home."  "Is everything okay?" he asked.  "I'm pregnant" I said, and, needless to say, he said he'd come directly home.  When he saw the test he agreed with me, no doubt a positive.  A faint one, but a positive.  I'm not an expert at much.  I don't think I'm even halfway skilled at much.  But if there's one thing in life I'm an expert at it's reading a pregnancy test.  After years of infertility and loss, I can tell you the difference between a true positive test line and an indent line, a dye run line, and an evap line (the last 3 being lines that aren't true positives) as easily as I can tell you if the sky is blue.  I always tell people that First Response and ClearBlue Easy should call ME to get advice on THEIR tests.  So that was it, I was pregnant (and a digital test confirmed the next day with the word "pregnant")

I ran off to Awana and vowed to myself to call my OB the next day for blood work.  I tried not to think too much into things...I've become decent at guarding my heart early on.  And so the next morning I called the moment they opened.  No one there - my doctor, the nurses, the front desk staff - is a stranger to my history.  I always joke that the nurses must roll their eyes when they hear that Lisa Stubblefield is on the phone, knowing I'm for sure a bundle of nerves about something.  But they are always gracious and get me in very quickly.  Literally an hour later I was sitting in the office, getting my blood drawn to check my hcg levels and my progesterone.

My OB, the sweet man that he is and having been with us through some of the best and worst experiences of his life, often calls me himself with test results, because he knows I'm going to have questions.  I knew they were running my blood work as "stat" and, sure enough, that afternoon my phone rang.  It was Dr. Lowe, calling me with my results.  My progesterone was completely fine, but what startled me was my hcg level.  It was a whopping ten.  A t-e-n.  For those not familiar with what hcg levels should be, that is lower than low than low.  It was literally HALF what my hcg was at the same point with one of my early miscarriages.  I'm still not sure how that hcg level showed up on a lined home pregnancy test, much less a digital one (which are usually less sensitive).  And, while miracles happen every day, numbers that low at that point aren't generally a good sign that things are going to progress in the right direction.  As soon as I heard that number, in my brain, it was already over.  I could tell from Dr. Lowe's voice that he wasn't too optimistic, either, but he didn't say as much (although he much later admitted to me that it was true).  I was briefly sad but "at least it's happening early" went through my head.  That sounds awful, but I know myself, and every additional day I'm pregnant I get exponentially more attached, and I come crashing down exponentially harder, emotionally, when things go downhill.  So, while disappointed and frustrated, I was just thankful that this wasn't going to drag along with us wondering what direction things were going to go.  As is standard procedure, my doctor asked me to keep coming back for blood draws every couple of days to see if that number was rising or falling.  And, wouldn't you know, that number just kept going up every blood draw.  Not just as much as it should, but MORE than expected.  By the time I was 5 weeks pregnant the number was exactly in the normal range for that gestation.  Things were starting to look pretty decent, and I was pretty surprised and exceedingly happy.  My OB scheduled me to come for my first ultrasound at 6 weeks 1 day.  

That first ultrasound appointment always throws me into a bunch of nerves.  Our first ultrasound with Lizzie looked extremely bleak, despite the fact that I went on to carry her to full term and have a healthy baby.  I never go into that 6 week ultrasound with much confidence.  But when that 6 week, 1 day mark rolled around, David took off work early, picked me up, and off to the doctor we went.  And the very moment the ultrasound tech pulled up that screen, there was that sweet little familiar-looking bean of a person, and immediately in the middle we could see the little flicker of heartbeat, which, to us, means everything (particularly since we didn't see that on our first ultrasound with Lizzie).  I've known what it's like to see tiny, 6 week gestation babies on a screen with no cardiac activity, and it sucks, so when that heartbeat is there it's such a thrill and such a relief.  I remember David instantly said "I see the heartbeat already!"  The little lentil-sized baby on the screen was measuring perfect and had a perfect heart rate.  Hurdle #1, overcome.

First picture of Katherine Belle - October 17th, 2017

A few days later we went to the State Fair in Raleigh, as we do every fall.  We spent the entire day there and I was still feeling pretty good with only minor pregnancy symptoms.  That evening, though, after returning home, I was hit with an extreme bout of nausea (which was likely not helped by the fair food from earlier that day) and I knew the pregnancy sickness had arrived.  I was SO happy.  Not because I love being sick, but because in my successful pregnancies I'm usually quite nauseous, and less so in the non-successful pregnancies.  So, as much as nausea sucks, for me it's always such a sign of hope.  I laughed because when I talked to my parents on the phone that night and my dad said "What did you eat at the fair?" I literally had to reply "I'm sorry, I can't tell you, because if I even think about food I'm going to throw up right now."  (Our parents and a few close friends already knew at this point).  Things seemed to be headed in the right direction.  

A couple of days later, as we were getting ready to go out to dinner for our 8th wedding anniversary, I had a little bleeding episode.  Nothing major and certainly nothing that would be ER worthy.  No cramping, no other symptoms.  I had some similar episodes in both of my successful pregnancies prior - with Joseph and Elisabeth - and all had been fine.  So, while I knew it was probably nothing, the concern over it still consumed my thoughts the entire time we sat eating at Liberty Oak.  Although I knew light bleeding in pregnancy was sometimes normal for me, I also knew that it had often been an ominous sign of the beginning of the end.  A couple of days later it was still happening, on and off.  I called Physicians for Women and gave the nurse a heads up.  She called back shortly thereafter and said she talked to Dr. Lowe and he wanted to see me that afternoon for an ultrasound.  I knew he wasn't worried, but he knew I would be worried if I didn't get to see what was going on.  So off for ultrasound I went.  

And, again, the moment the ultrasound tech turned on the monitor, I knew my fears were once again for nothing.  There was baby again...noticeable bigger than a week before (it's always amazing to me how rapidly they grow in utero), perfect heart rate.  Another sigh of relief.  7.5 weeks and all was looking really good...maybe this was going to be another "take home" baby in June (my due date was June 11th).

October 25th, 2017 - 7 weeks, 2 days
From that point on, things continued to progress along well for the next almost 7 weeks, until they stopped progressing at all.  My next ultrasound was scheduled for November 30th.  I would be 12 weeks 3 days at that point and David and I agreed that, if all looked good on ultrasound, we'd announce this pregnancy to the world that day.  Since all of my earlier losses had happened well before 12 weeks, 12 weeks for us has always felt like the safe zone.  We've always known something can happen at any point, but the risk of miscarriage after 12 weeks, quite frankly, drops to a fraction of a percent.  I keep saying that, before Katie, the second trimester was always my "comfortable time."  Before her, the first trimester always seemed scary because of our history of loss, and the third always seemed scary because that's when Joseph had his scary incident that almost left him stillborn.  But, before Katie, the second trimester had always been complication free.  I wish I could still say the same thing now.

During the weeks between that 7 week ultrasound and the 12 week one I battled some pretty extreme nausea...worse than what I ever experienced with Joseph or Elisabeth (and I had felt like those were pretty bad).  I remember one Saturday night that we went out to dinner I literally sat at the table with my head in my hands the entire time, avoiding food and doing deep breathing to try not to throw up at the table.  And it was unrelenting.  I admit, sometimes I complained and, even though I know that's normal, now I wish I never had.  It was a sign to me at the time that baby was doing well and thriving, and after her loss, when that nausea faded, I had never so badly wished to have a good reason to feel sick again.

Finally November 30th rolled around, and it was time to get a glimpse of baby again.  When that monitor was turned on, we were shocked at just how healthy that baby looked.  To be honest, she looked even healthier on ultrasound than Joseph or Lizzie did at that point.  Everything measured perfectly - her size, growth, heart rate.  Joseph and Lizzie went with us and enjoyed watching their new baby sibling squirm around on the screen.  David and I remarked about how calm this baby looked compared to Joseph and Elisabeth.  Both of them had been wild in utero, particularly Lizzie.  But this baby just squirmed around sweetly, occasionally wiggling their little bottom (so cute) and frequently putting an arm up next to their head (which I will now forever see as Katie's "signature move" as I kept remarking about it afterward).  It's hard to tell personality via ultrasound, although we've always been shocked by how similar Joseph and Lizzie act on the outside to how they acted on ultrasound.  We joked that maybe this was going to be our calm child.  She (although we didn't know it was a "she" at the time) seemed like the type that would just want to please everyone and stay out of the way.

Note that little hand up to her face...Katie's trademark.  

Another thing happened before we left my doctor's office that day...I had blood drawn for the Natera Panorama screening.  Panorama is a screening that screens the baby's DNA (from the mother's blood) for risks of various genetic issues such as Down Syndrome.  We had the same testing done when I was pregnant with Lizzie.  It is typically offered to pregnant women 35 or over, OR women who have a history of multiple losses, OR women who have a family history of birth defects (my older brother died shortly after birth from anenecephaly).  So, since I fit all three categories, they needless to say recommend this test for me.  And David and I have always seen it as a no-brainer for us.  Now, to clarify (as I have done in the past), terminating a pregnancy would NEVER be an option for us, regardless of any medical issues with the child.  Our resolve in that has always been firm.  We believe that each life created reflects God's image, and it's not for us to determine the time limits of that life.  So, even if a baby had something terminal, we would never end the pregnancy before it naturally ended itself.  But we've always looked at these tests as a way to prepare for any special needs that may lie ahead and, with my pregnancy anxiety, I tend to need all the assurance I can get that baby is healthy if baby is indeed so.  And last but not least, since Panorama actually examines the fetal chromosomes, it's a very accurate way to find out baby's gender earlier than one would typically find out on ultrasound.  I had my blood drawn as we were leaving with results expected in about a week.  We left, stopped by my parents house so they could take a picture, and put the announcement on Facebook.  I couldn't believe I was announcing that I was pregnant again.  There was a time in my life when I didn't think I'd ever get the chance to announce ONE pregnancy, must less over and over again.  We felt so blessed, and we were.  And we are.

Baby #3 was, in reality, our baby #9.  So many of them just never got to stay.  Nor would Katie.  I never would have thought, the moment this picture was taken, that anything would ever go wrong.

Neither David nor myself cared at all about gender.  Truthfully, we never have.  Couples with our history generally have one goal - take home a healthy baby from the hospital.  Whether baby was going to be a boy or girl was the furthest concern from my mind.  I have loved every minute of being a boy mom and have loved every minute of being a girl mom.  David has felt the same as a father.  We didn't care, we just were so excited to find out.  We were ready to give this baby a name (we already had names picked out for each gender) and start planning for blue or pink in our future.

The next week seemed forever, waiting to get our Panorama results back.  I had mailed two boxes of cookies to my in-laws, one blue and one pink, ready to tell them which box to open when we found out.  I was also planning blue or pink filled cupcakes to tell David (the nurse calls me with these results so I know first) and my family.  As anxious as I was to know the gender I was even more anxious to know that baby was low risk for all the things they tested for.  Finally, a week after that Panorama blood work, the call came.  It was Dr. Lowe's nurse, Gay (whom I adore...she goes to our church and has the sweetest spirit!).  The first things out of her mouth was that baby tested low risk for everything, which was music to my ears.  Then, after confirming that we did indeed want to know the gender, she happily said "You're having another little girl!"  I couldn't believe it.  More pink, more bows.  Immediately in my head flashed images of our new baby daughter and her older sister in coordinating outfits (in retrospect, what a shallow first thought, but I've never pretended not to love dressing Lizzie up).  I immediately set to work on filling cupcakes with pink icing for David and my parents.

David got to bite into his cupcake first, when we were still at our house, just the four of us.  He was SO excited.  He had thought all along that this was a girl.

We went to a quick dinner then headed to my parents house, where all of the parents would find out her gender together - David's family over the phone with cookies, and my family in person with cupcakes.  Everyone was extremely happy to see pink!  We also announced her name - Katherine Belle Stubblefield.  It had been a long process for us to come up with a name for this baby, but just a few days before the Panorama results we had finally been able to do so.  Neither Katherine nor Belle are family names, we simply liked them.  We were after classic (which we felt like Katherine met) and Southern (which we felt like Belle met).  In addition, "Katherine Belle" means "Purely Beautiful," and she was.  I'm so happy we named her what we did.  We would call her Katie.  "Lizzie and Katie," we thought, sounded like a good sister pair.

I was set to have my next appointment just a few days after this gender reveal, my 14 week appointment on December 11th.  I was also starting to feel very very tiny baby flutters.  They were very light, almost like a butterfly inside of me, but they were there.  Women tend to feel movement earlier and earlier in each pregnancy, and I've always been unusually sensitive to baby movements.  I felt Joseph at 18 weeks, Lizzie at 15 weeks, and, a few days before 14 weeks, I was already feeling "Katie flutters."  But early on those little flutters tend to be very sporadic.  Baby is only a bit bigger than a lemon, so depending on their position there may be days with no feeling of movement at all, until they grow a little more.  So I certainly thought nothing of it when I felt movement for a few days, then felt nothing.

The 14 week appointment is pretty routine.  Your OB uses the Doppler to listen to baby's heartbeat and that's pretty much the whole thing.  After seeing us through all of our infertility, all of our miscarriages, and two full term pregnancies (and delivering both of my children), Dr. Lowe doesn't even attempt to make me rotate through doctors any more, as is standard procedure at my practice.  I really only feel comfortable with him, and my husband feels the same way.  After Joseph's scary delivery and then all of our miscarriages I was such a basket case that I always saw him at every appointment during my pregnancy with Lizzie (except for two in my third trimester when he was out of town) and we, of course, confirmed early on that I would see him every appointment with this pregnancy.  I had also already confirmed with him that he would induce me at 39 weeks, whatever day that week he was on call.  He also did this with pregnancy anxiety is so bad that a) I need to get baby out at the earliest possible safe date to know that things are okay and b) my anxiety also really needs my own doctor to deliver my babies.  I felt like I had all of my "anxiety hedges" in place and at this point I was feeling really good about things.  Truthfully, walking into my 14 week appointment on Monday, December 11th, I NEVER would have guessed that ANYTHING would have been wrong.  Oh, how naïve I was.  I had left the children with my parents instead of bringing them with me, as I had initially wanted to do.  In the end, that move ended up being providential.

When Dr. Lowe came into the room we briefly joked around like we always do, discussed how excellent Katie's Panorama results were, and talked about our being excited that it was another girl.  When he put the Doppler on my stomach, I honestly wasn't even nervous.  It always takes a while to find my babies heartbeats on Doppler and so I expected nothing less.  He searched and searched and searched and searched.  And nothing.  He kept searching.  Still nothing.  I think he thought I was getting nervous, but at that point I really wasn't.  I said "She's really good at hiding, isn't she?" and we laughed.  Then he asked a nurse that happened to be popping in to get something if she would go get the handheld ultrasound.  I was simply amused over what I assumed was Katie's elusiveness at this point, and Dr. Lowe didn't really seem worried, either.  The only one moment of pause I had was when the nurse returned with the handheld ultrasound device.  For a split second it hit me that he had explored basically my entire abdomen with the Doppler, and I wondered "WHERE could she possibly BE?"  But I quickly pushed that thought out of my mind and assumed I was just being ridiculous.  When he put the ultrasound wand on me she was right underneath.  We saw her immediately.  The handheld ultrasound is a bit grainy and not the same quality as a big ultrasound, but I was so happy to see her little self there.  So I immediately started scanning her chest for that little heartbeat flicker I was so accustomed to.  I started looking for her to move.  Becoming increasingly confused, I realized I DIDN'T see that little heartbeat.  She wasn't moving.  But reality was not yet sinking in.  Maybe she was asleep?  Maybe my vision was just bad?  I was sure I was just missing it.  Dr. Lowe was oddly quiet.  Neither of us said a word...the room was silent.  I'm used to him instantly saying "See, there's baby, there's heartbeat" but he said nothing.  My eyes left the ultrasound screen and glanced to his face.  I've been with Dr. Lowe for years, I know his demeanor pretty well.  And I knew this was not altogether typical.  He was very calm, yet silent, with very little expression on his face.  Thoughts started going through my head, rapidly.  Surely not.  It's not what I think.  I'm just my crazy self, reading into things.  It CAN'T be that.  After, maybe 10 seconds, I had the courage to say "Do you see her heartbeat?"  I was fully, 100% expecting him to say "Well, yeah, it's right there."  I was sure I was just missing it and he'd reassure me.  Instead there was a pause.  Then he said, very seriously, "I'm looking."  At that point, I felt everything starting to come crashing  down.  I didn't react yet, I thought there must be some mistake.  He kept looking.  I felt my heart beating faster and my blood pressure rising.  After maybe 10 more seconds I said to him, with a hint of desperation, "I don't see anything."  I wanted him to tell me I was wrong.  A few more seconds of silence then he let out a deep sigh, shook his head, and just said "My goodness."  And then I knew.

I don't think I can ever express to anyone exactly how I felt in those seconds.  I'm sure another pregnancy loss mom would understand, but otherwise, I feel like it's a place you have to have been in yourself to understand.  In the same way, I cannot possibly pretend to imagine how it feels to lose a 4 year old, or a spouse ,or to be diagnosed with a terminal illness.  I'm not sure I've adequately expressed how that moment felt to me even to my own husband.  The questions, the feeling like you're going to die.  They were all there at once.  I immediately burst into tears.  I managed to say, to Dr. Lowe "Can I call my husband?" and he said "I think you should."  He quickly told me that he wanted to send me to the main ultrasound to confirm, and that he was hoping he was wrong, and I knew he that's what he was hoping, but, deep down, I knew he WASN'T wrong.  He left the room to get the ultrasound tech and I somehow dialed David after multiple tries.  I was hysterical, shaking, not thinking straight.  I couldn't remember which number to call him on.  I didn't know what I'd say, or how I could even talk clearly or calmly enough for him to understand me.  When I finally figured it out and he answered all I could say was "She doesn't have a heartbeat."  He became likewise hysterical and all I know is that he was in the car within about 20 seconds and headed towards me from his office in Burlington.  I knew how upset he was and I kept asking him to drive carefully.  I couldn't handle the thought of something happening to him, too.

The moment I hung up the phone the door to the exam room flew open.  It was Gay (Dr. Lowe's sweet nurse that I mentioned above - he had obviously gone to get her as well), Kelley (the amazing ultrasound tech who has seen me through all my pregnancies) and Dr. Lowe.  At various points I remember collapsing into the arms of all three of them.  I've always been one to have really random thoughts in the midst of high emotion, and I remember realizing that I had soaked the shoulders of all three of their scrubs in tears, and that I felt bad about that because they were probably going to look pretty unprofessional walking around with wet shoulders in front of other patients.  Who thinks about this type of random stuff?  Me I guess.  Ultrasound tech Kelley helped me down from the table and Dr. Lowe picked up the stuff I had brought with me (my jacket, planner, etc) and carried it along to the ultrasound room.

As soon as she started the ultrasound it confirmed what I already knew.  Katie was utterly still, lifeless.  No cardiac activity.  Not only did she look for her heartbeat, visually, but she turned on the heartbeat audio twice.  Nothing.  I could also see signs around Katie that something looked odd.  I didn't know what I was looking at at the time but now I do...she had pockets of fluid around her - fetal hydrops.  What hit me hardest of all was her arm...she had flipped around and changed positions since our ultrasound from a week and a half earlier, but she still had a little arm up by her head, just like she did the last time we saw her alive.  I knew David was a) horribly upset and b) driving, so I have no idea why I would text him at this time and add additional distraction, but I did.  I just said "Ultrasound confirmed, she's gone.  Please be careful."  Kelley stayed with me for a little bit and was so, so, so sweet to me. She said that they knew I didn't want to be out in a waiting area while I waited on my husband (the thought of sitting in a room of pregnant women at that point seemed like it would be the icing on the very awful cake).  So she took me to Dr. Lowe's office, closed the door, and let me wait in there.  I knew David was only about 5-10 minutes away at that point.  After waiting about 3-4 minutes Dr. Lowe popped in to check on me and hugged me.  I just kept crying.  I probably had 50 tissues in my hand, all soaked in tears.  I'm not certain, but I think I used almost the entire box on the table in his office.

Katie's ultrasound on the day of that horrible appointment

Next thing I knew David had arrived and they brought him directly back to Dr. Lowe's office.  We hugged and cried together.  Dr. Lowe came in and I apologized for being so hysterical (though I remained hysterical) and he told me "Don't apologize.  A lot of us here are taking this very, very hard.  It's a sad day for all of us."  He sat down to discuss ideas on what may have happened, and what we could do as the next step.

He said ultrasound evidence pointed to something just having happened to her within the last few days before my appointment, and that it's possible it was a chromosome issue, although the Panorma screening would have ruled out the common ones.  He also, due to the hydrops, recommended that I have titers done for CMV, Toxoplasmosis, and Parvo.  These would tell me if I recently had an infection that could have killed her.  But first we needed to talk about how to get her out of me, which is a horrible conversation for anyone to have to have.  He gave me the option of waiting out a natural miscarriage, which is what I had always done in the past.  The issue here was that I still had my nausea and all of my other pregnancy symptoms.  He said my body literally "had no idea" that our baby was gone, and that waiting it out could take a very, very long time (my second natural miscarriage at 6 weeks took nearly 3 months to fully complete, so I couldn't imagine how long this may take).  Not to mention that miscarrying a 14 week baby naturally would rival the pain of labor.  It was two weeks before Christmas.  My early miscarriages had been (physically and emotionally) painful enough, and I didn't see how I could deal with the pain of a natural miscarriage at Christmas time.  We were hosting my entire family as our house for Christmas Day, for Heaven's sake.  What was my other option?  The other option was, of course, surgical management.  A D&E, which is a slightly more involved version of a D&C, reserved for second trimester miscarriages when baby is bigger.  I know some doctors also give moms the option of having labor induced for second trimester miscarriages, too, and had I brought that up I suspect Dr. Lowe would have been on board with that, too, but at that point I didn't see how I could take more emotional pain that I was already experiencing, much less intense physical pain, for a baby that wouldn't be born alive.  After just a quick discussion with David we decided that a D&E would be the way to go.  It was scheduled for that Friday at Women's Hospital.  We went to my parents house to pick Joseph and Lizzie up.  In the car, I blurted out the truth to Joseph - baby Katie was dead.  She had gone to be with Jesus, and she wasn't going to be coming home with us in June.  He burst into tears and sobbed "Dear God, please please bring baby Katie back to us!  Please!"  His little heart understood so much, maybe too much, but there was no way around the truth.

That week was a complete blur in some ways but horrible burned into my memory in others.  David took the entire week off of work to be with me, so we could grieve together.  I can't even begin to detail the private moments of that week.  All I'll say was there was a lot of crying.  I cried so much that my mouth would literally get dry from dehydration.  I still had all of my pregnancy nausea, which was a cruel reminder that her body was still inside of me even though her soul was not.  I would say I spent probably 80% of every day that week crying.  I was too nauseous, both from pregnancy hormones and from grief, to eat.  And I was too distraught to sleep.  I started rapidly losing weight and the lack of sleep basically made me a total zombie.  I felt completely empty.  I remember hanging on David's shoulders one night and crying "How are we going to live without her?!"  I really didn't know.  Another question kept tormenting me as well...a question about what awaited me that Friday during the surgery.  I'll spare people the details of a D&E (if you're really curious there is no shortage of information on Google).  But let's just say it's virtually the same procedure used during a late term or dismemberment abortion (except, in my case, Katie was obviously already gone).  I could turn this into a discussion about just how much multiple losses have reinforced to me the injustice of abortion, but it would be too much to write here.  There's nothing about it that isn't horrible.  The mom is put under general anesthesia, of course, so I knew I wouldn't be aware of any of it at the time.  But, although I knew surgical management was probably the best option in this situation, both physically and emotionally, I was haunted with thoughts that I was a terrible mother for robbing Katie's body of it's dignity by allowing them to tear her apart in the OR.  So many times in that 5 day period I asked David "Am I a terrible mother?  I couldn't protect her when she was alive inside of me, and now that she's dead I'm going to let them rip her apart to get her out of me...I must be the WORST mother."  David would, of course, assure me it wasn't true.  He kept reminding me that her soul was with Jesus and it was only her body that they were removing.  And reminding me that I didn't choose any of the things that happened to our babies.  But still.  And there were the other questions - HOW could this have happened?  She looked so healthy up until she was...gone.  Did she suffer?  What if she suffered for days and I didn't know?  It was an absolutely horrible time in my life...I've never felt that type of darkness and sadness.  Our friends and family rallied around us and were absolutely amazing.  I'm only able to touch very lightly here on the magnitude of how they supported us during all of this.  In particular, a dear friend of mine who lost babies at 19 weeks and 22 weeks, respectively, constantly reached out to me and counseled me with her wisdom from those dark times in her own life (And the road she has walked, I cannot imagine.  Like I've mentioned before, I get exponentially more attached to my babies each day a pregnancy continues.  I can't even begin to imagine what she has gone through or how she has survived).  We took the children to the Science Center two days after finding out she was gone, which was also 2 days before my surgery.  We felt they deserved something other than seeing us both sitting around and crying all of the time, and if nothing else it was a couple of hours in which we were forced to stop crying long enough to appear okay in public.   As horrible as it was, though, I also felt God taking care of me during all of this.  Remember when Scripture talks of souls under such distress that they can only groan to God instead of forming actual prayers?  That's where I was at.  In the shower every day, away from Joseph and Lizzie, I would become hysterical, and all I could say to God was "I love you, I trust you, there MUST be good to come out of this...but help me, Lord.  You have to help me to survive."

Thursday, the day before my D&E, we went for one final ultrasound.  We knew Katie was gone, but since David wasn't able to get to the doctor's office (the day we found out she was gone) in time to see that ultrasound, he felt like he needed to see her one more time for his own closure.  I knew my OB would let me do this if I asked, but I also knew that insurance likely wouldn't cover it.  So I decided our cheaper option would be to go to a private ultrasound business in town, one that mostly specializes on doing pregnancy ultrasounds "for fun" and for the purpose of finding out gender.  I had called them a couple of days before to make an appointment and the lady was so, so nice to me over the phone, particularly considering our unique situation and the fact that I was crying while we talked.  So Thursday afternoon we dropped off the kids with my parents and headed to that appointment.  I had several glasses of wine before we left.  I'm not proud of that, but it's where I was at the time.  When we got to this ultrasound place a couple in the waiting room immediately struck up a conversation with us.  They were waiting for the tech to finish printing their ultrasound photos...they had just confirmed that their second baby was going to be a girl.  They were very nice and we told them congratulations, but I knew the conversation was eventually going to head somewhere I didn't want it to go.  A few seconds later it happened.  The man asked "So, are you pregnant with your first?"  My brain quickly searched what to say.  So many jumbled thoughts.  No, it's our 9th.  But she's dead.  And so are 6 of the others.  But I couldn't say any of that.  So I just said "We have two children at home.  We're just here for an ultrasound for closure...unfortunately we lost this baby."  Their faces turned white and they immediately apologized (as if any of it was their could they have known?)  They very sweetly asked for our names, and asked if they could add our name to their prayer list at church.  Yes, of course, thank you.  Then it was our turn.

I was pretty terrified of how Katie was going to look on this ultrasound.  I knew the hydrops had caused fluid to surround her body, and in the three days that had passed since seeing her last I could only imagine it had gotten worse.  The ultrasound tech was so kind to us.  She turned on the monitor and there was Katie.  To my surprise, the hydrops hadn't gotten tremendously worse since Monday, which was a relief.  She started pointing out all of Katie's parts to us...she was very thorough.  I think she wanted to make sure that, since this was the last time we'd see her, that we saw as much of her as we wanted.  I knew this place also had 3D ultrasound capabilities, but the package with that costs much more, so we had not planned on that.  Nor was I even sure I'd want to see her on 3D.  I thought it may be too real.  But, just like that, the tech ended up flipping on the 3D feature (which they, in their mercy, charged us no extra for) and there she was.  Her perfect little face, her arm up by her head.  It almost looked like she had hair, but I knew the dark spot on her head was only fluid.  I'm so, so glad we saw her in that detail.

3D Ultrasound

When we left the ultrasound, we knew that was it.  We'd never see her again on this side of eternity.  And honestly, after that, I was just ready to get the D&E over with.  I kept telling David that walking around, knowing she was dead inside of me, was too much for me to handle.  I just wanted the physical part to be over.

I wasn't allowed to eat anything after midnight to prepare for the procedure the next day.  It was surreal, I went to bed with the same nausea I'd had for weeks and weeks and weeks, but knowing no live baby was going to be coming home with us.  I had two dreams that night.  One was a horrible nightmare - that I woke up during the surgery and felt her being taken from my body.  I woke up sobbing uncontrollably.  Then, when I got back to sleep, I dreamed that David and I were talking to Dr. Lowe, and I was telling him that I knew I was a terrible mom or not protecting Katie or all the other babies we lost.  But I kept asking him if it still make me a "sort of" good mom that I put such nice bows in Lizzie's hair.  It made no sense and the second part was even pretty funny, but it was clearly a reflection of the guilt I was feeling for losing all these babies.  My thoughts, my dreams...they were just a mess of darkness and confusion.

The next day we got up and just hung around the house for a while.  We were supposed to be at Women's Hospital at noon.   Around 10am I took a shower.  When I got out, suddenly everything got to me on a very physical level - the pregnancy nausea, the emotions, the low blood sugar from not eating since the night before.  I wrapped myself in a towel and laid down on the bed...crying, shaking uncontrollably, trying not to throw up food that wasn't there.  Finally I got myself together, got up, dried my face, got dressed, and got my paperwork together for the hospital.  I wasn't showing much by the time we lost Katie, but I still had a small, noticeable baby bump.  She was still inside of me and I didn't want to forget that, so I took one quick baby bump picture right before we walked out the door for the hospital.

My one and only "baby bump" shot from my pregnancy with Katie.  Taken a couple of hours before my D&E.

My parents met us at the hospital.  I wanted David to be with me in pre-op as long as they'd let him, so my parents came to keep the kids in the waiting room.  They could have stayed at their house, but it was important for me to be able to see the kids as soon as possible after waking up, so I wanted them there.  The first place we had to wait was in the lobby of the main entrance.  It's the same place that parents bring newborn babies out while be discharged.  And we were there at discharge time.  I counted 7 healthy newborns coming out, including a set of twins.  I remember one set of parents didn't even look happy (in retrospect they were probably just tired) and I truthfully, at the time, wanted to run over and punch them in the face.  Didn't they see what they had?!?!  And what I didn't?!?!

The kids playing in the lobby when we first got to the hospital.  For all the Christmas décor, I wasn't feeling very Christmas-y.

After maybe 20-30 minutes, a lady came to get me and to get David.  She took us to a small room to ask questions about my medical history, insurance, etc.  My parents took the kids to the hospital cafeteria to eat.  As soon as we were done with the questions, they took me back to the pre-op area and told David to go back to the waiting area.  They promised to come get him the moment the had me all gowned up and my IV started.

The nurses in pre-op were so kind and so sympathetic.  They got my gown on, which was a new contraption I'd never seen called a "Bair Hugger System."  It's a gadget made by 3M which basically is a gown that can hook to a machine that blows warm air into it.  It is meant to combat surgical hypothermia by warming up the body temperature before and after surgery.  It felt good, but looked ridiculous as the puffy gown makes you look about 4 times your normal size.  Yes, we have pictures of this, and no, I won't post them here, because I looked absolutely absurd.  But I was kind of grateful for that, because at least it was something to laugh about, however small.  Once my IV was started the nurse went to get David to join me in pre-op.  As soon as he walked in and saw me in that gown he said "Well, you're looking awfully busty!"  I laughed again.  It felt utterly ridiculous to be laughing at anything at that point, but I knew it was good for both of us to laugh when we could.  A few moments later Dr. Lowe came in to talk to me before surgery.  And of course, the first thing he said was "Well, look at you, all puffy!"  This gown was really the source of a lot of humor that day.  In some sense I almost think God had 3M make these gowns just to give me a brief respite of humor in such a dark time.  Dr. Lowe knelt next to my bed and asked David and I both how we were doing.  He had so much sympathy and pain for us in his eyes.  We had already decided we wanted to send Katie's tissue for genetic testing to see if that would yield any answers, and I asked him about what that process would be like.  He said they would send it to the genetics department at Wake Forest Baptist Medical Center, where they would actually grow out additional chromosomal tissue to be analyzed.  We'd likely have answers within 3 weeks.

Before any surgery I've ever had they've always given me what I call the "happy meds."  They give it to most people right before rolling you to the OR.  I don't know what it is, but I've always joked that I wish it could be purchased over the counter.  It's like being very, very, very drunk, and, in those few moments before they actually put you under, you don't much care what's going on around you.  Maybe it was just the type of procedure or maybe it was because of my emotional state, but I feel like they gave me about 3 times as much of the "happy med" in my IV than I'd ever had before my laparoscopic surgeries for endometriosis.  Within 30 seconds I was feeling loopy, and things became fuzzier and fuzzier from there.  David could tell right away it was taking effect.  I started talking a little bit of nonsense.  David kissed me when they wheeled me off to the ER, but I don't remember it.  I was too doped-up.  What I do remember is that, in the hallway on the way to the OR, I started telling the anesthesiologist and the OR nurse all about our plans to homeschool.  Why I did this, I have NO idea.  But I couldn't stop.  I remember some of the sentences I said didn't come out quite the way they were arranged in my head.  Looking back, it was really comical...I've laughed many times over it (again, I have to laugh at what I can).  Somewhere down inside of me I thought "Lisa, the words coming out of your mouth aren't making're embarrassing yourself!" but I literally couldn't stop this vomit of random information about the education plans we had for our children.  Everyone very politely nodded along and even asked me further questions about stuff I was staying (which I'm sure was mainly out of politeness but also potentially for their own amusement, and I wouldn't have blamed them).  Once in the OR I remember them moving me over to the table and at that point I was just so loopy that I was just barely aware that I existed.  But I STILL kept babbling to the entire OR about homeschooling, ad nauseum.  Suddenly Dr. Lowe appeared at my left side and he took my hand.  I remember thinking how true to form that was of come up and comfort me before he did a procedure that he wasn't going to enjoy any more than I was.  He's such a kind person and physician.  It briefly went through my head that I should say something like "Thank you for being so kind" but instead, in my stupor, I chose to continue the homeschooling babble and tell him why I decided to wait until this fall to start kindergarten with Joseph.  I was utterly incoherent at this point.  I remember, while I was still talking to Dr. Lowe, the anesthesiologist putting a mask over my face, and the last words I heard were "We're going to take good care of you."

In what seemed like seconds later (in reality it was an hour) I started to slowly wake up in recovery.  I'm always very very slow to gain awareness coming out of anesthesia.  For a second I had no awareness of where I was, what had happened, or that Katie (or anyone else) had ever existed.  I wasn't able to open my eyes yet.  Then I realized my abdomen felt crampy and also incredibly empty, like something that had once been there was no longer there.  And then I realized everything.  I could hear two nurses talking to me.  I said "Is it all over?"  And one of them said "It's all over, sweetheart."  And I started crying.  I remember apologizing to them and saying "I'm sorry.  I just miss her so much."  I remember them drying my tears with a tissue.  Then Dr. Lowe was back at my side.  I still wasn't able to open my eyes yet, but I was becoming cognizant enough to realize he was talking to me and to understand.  He told me all was fine and that he had already talked to David.  He also joked that he didn't believe all the crazy stories I'm always telling him about Lizzie's demeanor (despite the fact that he's seen it many times in his office!).  He said he had just seen both kids in the lobby and Lizzie was being an angel.  I jokingly told him "Well, take her home with you for 24 hours then and see what you think after that" and he and the two nurses laughed, as did I.  Then I went back to crying.

It didn't take me terribly long after that to get awake.  The nurse asked me what my pain was on a scale of 1 to 10 and I said I didn't know, maybe a 6.  So she put some pain meds into my IV.  About 10 minutes later she asked where the pain was on the scale now, and I said "Oh, it's much better, probably a 2.  Not much at all."  She said "Well, we can knock that last 2 out for you if you want."  Normally I'd say no, but I didn't want to be dealing with anything at that point that I didn't absolutely have to, so I said "Sure, go ahead."  More pain meds in the IV, and then, physically I felt very little.  After a little while longer she unhooked my IV and got me up to go to the bathroom to get dressed.  I was bleeding a good bit and feeling very dizzy and lightheaded.  They moved me to the other side of the recovery room where they sat me in a chair and got me some Pepsi and graham crackers.  They let David come in and join me.  I alternated between just staring, weak and lightheaded, and crying over everything that had happened that week.  Dr. Lowe came in and spent some time talking to us and going through post-op instructions.  When he saw how lightheaded I was he and the nurse spent a few moments discussing whether or not they should give me more fluids, but I was just ready to get home, so I said I was fine.

My recovery, physically, was very easy.  Surprisingly so.  Within 24 hours after D&E, the pregnancy nausea was completely gone.  It was both a horrible reminder of what had happened and a great relief that I no longer had to feel symptoms from something that wasn't there.  Lizzie napped on my chest that afternoon while I lay in our recliner, recovering.  And both kids enjoyed roaming around the house wearing Dr. Lowe's surgical cap, which he had given them right after the D&E was over.  The next day, I felt like walking out in the backyard while David raked leaves and that evening felt like going out to dinner for my mom's birthday.  The physical part was finished, but the emotional recovery was just beginning.

Part #2 coming tomorrow...