Crisis Averted....Maybe

My firstborn is not much of the adventurous type. And yet.... last week she took a swan dive off the second-floor balcony of a Dutch-style garage at her grandparents house. She landed ON their driveway.


We aren't exactly sure how it happened. My mother had just brought the kids home from a day of errands and adventures. It was about 4:45, and my dad had just gotten home from work. He was "tasked" to watch the kids as they played outdoors. My son is a sweaty little dude and it was hot, so my dad decided to get them some water. My eldest had just started walking up the exterior stairs when my father told her to "Get down from there" before he headed inside. While inside, he grabbed their water and some stale bread to feed the turtles in the pond beside their house.


He was gone for maybe one minute.


In the span of sixty seconds, my child climbed the stairs, leaned against the railing, broke said railing, and went flying between the top rail and the balcony platform, FOURTEEN FEET to the concrete driveway below.


My father didn't see the fall. He saw my daughter getting herself up off the ground, crying, bloody mouth and nose. My son protested that he saw her fall and was a bit freaked out about the blood. He was given a popsicle and escorted indoors and was henceforth oblivious to all that followed. My daughter carried herself indoors of her own volition. She had wet her pants at some point during this fall or immediately after, and she changed her clothes. All was thought to be well because my dad thought she fell while running on the ground. But she told him, "No, I was up there," and pointed to their garage. Then, he saw the broken railing. Then, she wanted to go to sleep - a sure sign of a concussion. So, after some consultation with nurse-friends and us (the parents), they called 9-1-1.


Paramedics arrived and began doing some cognitive awareness testing. They asked her name, age, birthday, and the like. My daughter turned to my mother and said, "Nana, will you answer their questions so I don't have to?" She was still sassy! She protested when they made her get on the backboard with a neck brace. My dad convinced her it was a princess crown you could wear on your neck. How that logic worked, I'll never know. I guess you have to be six years old to get it.


My mom rode in the ambulance with her. They had to keep her awake because she kept trying to fall asleep. She had a full body CT scan, during which they found no internal bleeding, no brain swelling, no hemorrhage, an no inflammation. They did, however, find a basal skull fracture running from about the top curve of her skull to about the middle of her forehead. The two bones were not misaligned, and there seemed to be no concern that she would be leaking cerebrospinal fluid or have any swelling or bleeding there. You can't even see a bump or scratch there. It's on the inside.


What you could see by day two, were the tell-tale raccoon eyes of a child with a head injury. Both eyes grew black. One swelled shut. She had a couple of scrapes on her cheek and nose. She had a hematoma on her knee, where it obviously had made a big part of the impact. She was kept overnight in the hospital. My mother stayed with her, bless her!


The hard part for me was not rushing to her, not being there for her. My baby girl! There was nothing I could do but be a mom, which would have been more than enough I'm sure. But, I knew she was in good hands and that my being present would take moving heaven and earth. Being military (and since this occurred after business hours), I would have had a nightmare on my hands trying to secure emergency leave and drive the 5 hours (after a full day's work) to my parents' hometown. I would have missed my first day of clinical training at my practicum site. I would have done all of these things in a second, if I had felt I needed to. But I didn't need to.


The second hardest part was controlling my reaction to seeing her in person for the first time after it had happened. My child is not self-conscious in the least. But I didn't want to scare her or make her worried if I reacted poorly to her injuries.


Now, five days after the accident, she is back to her sassy, bossy self. One black eye is cleared up. The other will clear in a few days. The scrape on her nose is gone, and the one on her cheek will hopefully clear up in a couple of weeks. Her knee isn't swollen, and the bruising is almost gone. No other broken bones, no spinal injury, no permanent (we think) repercussions of her concussion.


She starts first grade tomorrow. We will take her out after a half-day, to have a follow-up appointment. I think the hardest part of all will be telling an active six-year-old that she can't run and jump on the playground at recess, that her feet must be on the ground at all times, that she cannot go back to Taekwondo for three months, and that she can't wrestle with her brother. I mean, we do tell her that last thing, but it hasn't worked yet. How does one keep a bird on the ground?


The thing we have learned is that it only takes a minute for something bad to happen. The consequences of one brief action could be long-term - and that is the lesson I hope our daughter learns from all of this. That, and, when Papa tells you to get down, GET DOWN!

Moving On

It has now been six months since we lost our little one. I have heard some women say that the only thing that made them feel better was trying again. I have felt better. Much better, most days. I have also felt numb and raw pain, but not nearly as bad as at the beginning. And I still feel like someone is missing from our lives.


So, we have decided that our way of moving on will be to try again. We have talked about it for a couple of months and have had a window in mind. I will have to start my pre-doctoral internship next fall. Our options are to try now and hope for a baby before my internship begins, or to wait until sometime during the internship to try again.


It's frustrating that we have to plan so much around all the things in our lives. I am "old" in terms of birthing years. Any pregnancy we have now will be considered high risk because of my age. No, I'm not signing up for AARP or anything, but risks start to increase at my age and fertility starts its gentle descent.


We don't really know what the future will hold. But maybe, just maybe.... I'll get to start blogging about pregnancy again.

The Honesty of Children

The three-year-old will look me in the face (when I can see his wet pants and the circle on my favorite blue chair) and say, "No!" when I ask him if he peed on my chair.

The six-year-old will look me in the face and say, "He just fell down!" when I saw her push her brother less than a half-a-second ago.

But sometimes, they don't know how to be anything other than honest. And sometimes, it's brutal.

Many parents opt to wait to tell their children that another one is coming. Sometimes, they wait until one of them rudely shouts out, "Mom is FAT!" Sometimes, they wait until after the first trimester is over. Sometimes, they wait until they get the positive result back from the doctor's office (serum test) after they've peed on a stick at home. So, we're those last people.

When we found out we were pregnant, we couldn't wait to share the news with our little ones. They have only been asking for like MONTHS if we were going to have more babies. They had even chosen the gender they preferred (each originally chose a same-sex sibling, but then the boy changed his mind and decided that he wanted a second sister). The eldest even chose a name (Daisy Sunrose). Don't ask.

So, when we found out we had miscarried and there would be no new baby after all, it wasn't easy to break the news to them. This, after all, is the very reason that so many parents choose to wait.

The younger is three. I think he had forgotten there was a baby in Mommy's tummy. He seemed sort of oblivious. The older is six. She knew, but nothing we said really explained it to her. She seemed confused. "The baby is coming early?" she asked. No, not that. "But the baby's not in your tummy anymore?" Right. "So where is the baby now? Is she at the hospital?" No, no, no. Finally, I said the hardest thing I've ever had to say. "The baby died, honey. The baby is in heaven." Click. Light bulb. The look of recognition on her face was enough.

But then, she came over and kissed my tummy and said, "Goodbye, baby."

She probably couldn't understand why I was crying. Or maybe she did. Which is why maybe she thought it would somehow make me feel better to know how glad she was that I could pick her up again. Only, it didn't. I cried more. Daddy had to take over for a while, as I went to lie down.

Sometimes, kids don't know how to be anything other than honest. And sometimes, it's better to hear the lie.

Healing Ain't Easy

There are no shortage of people in the world who aim to be helpful when others are grieving. Sometimes, people's way of being helpful is to give you space. Sometimes, they want to give you copious amounts of baked goods. Others want to dispense with advice. While well-intended, the advice-givers tend to be the ones that, despite their best efforts to be helpful, just aren't.

Advice and "tidbits" that either I or my husband have been given since our loss:

• "You'll get over it soon." Let's break that sentence down. On the surface, it seems pretty benign. But let's put the lens of grief on and take a second look. The phrase, "you'll get over it" is a brush-off, disregarding how painful and difficult it is (or maybe even impossible it is) for a person, in that moment of grief, to be able to see the other side of the mountain. And "soon" is relative, friends.
• "You can always have another one." This isn't like a car I really liked and just need to get a new one. This isn't even a favored pet that just died. This was a child. My child. And along with the hopes and dreams that go along with a pregnancy, all of those things died with him or her.
• "Did you know if it was a boy or girl?" I don't hate this entirely. Asking questions are better than assuming one knows everything ever and tries to share this amazing knowledge. But I am not at a place where I can consider the possibilities of a son or daughter that I will never know. The development stopped well before any sex organs would have been visible. So, in addition to not knowing the sex of my child, I have the pleasurable agony of adding to that thought that I will never know.
• "Have you thought about adopting?" Yes, we have. In fact, we'd considered doing that instead of/in addition to/before/after/whatever having a third biological child. We made a choice to expand our family biologically one more time (or whatever, maybe two more times). It doesn't mean we can't adopt. It doesn't mean we don't want to. But now isn't the time for me to prepare the mountain of documentation for an adoption. I'm just trying to get my taxes done for now, thanks.
• "Oh, I had a few of those [miscarriages], and I'm okay." First, okay, that really sucks for the individual who said this. Second, having anything bad happen to you once, twice, or seventeen times and surviving doesn't mean that everyone can, should, or will be able to just "be okay" with what happened, just like that.

One thing I am worried about is the gradual disappearance of compassion when I share my story. I'm struggling right now. Struggling to keep my temper in check with my kids, struggling to get all my work done, struggling to meet some milestones, just struggling. And I wonder how long the clock of compassion will tick inside the heads of those around me before they think, "Okay, she should have grieved long enough." How long before the expectations that I am "over it" start to change the way I interact with people who have these expectations? Or the way they interact with me?

How long is the timeline for grieving?

Grief is not finite. I'm learning that there are some days when I wake up and it feels like some kind of surreal dream, where I'm not even really sure if anything happened to me at all. Sometimes, I wake up and feel like the wound is wide open and raw, the pain so real and awful that I want to just scream into my pillow. Sometimes, I do. There will be days like each of these. There will be days when I feel "normal" again. There will be days when I don't think about the baby I wanted to hold. But not right now.

Right now, I block people's Facebook posts who have just announced their pregnancy. And the due date is too close to mine. In my head, I still have a due date. I imagine that when August comes, I will grieve some more. And by then, people will have decided that my deadlines are more important than whatever else is going on. By then, most people will probably think I should be "over it." 

The Thing We Never Talk About

Today, I'm going to talk about something that nobody talks about. People don't really want to talk about it. It's hard. It's sad. And if anyone has to endure it, they want it to go away quietly because it's too hard to share. I'm talking about miscarriage. And it happened to me.

Within the past two weeks.



These are the things I have learned about miscarriage in my Internet research and conversations with my health care provider.

Why Does it Happen?
The short answer: no reason, or a gazillion reasons. The longer answer (but still not very satisfying), is that sometimes abnormalities within the egg or the sperm (e.g., not enough chromosomes, too many chromosomes, errors in the DNA code that instructs the embryo on how to form, etc.) cause the development to stop early. Sometimes, environmental factors (e.g., toxins in the water, air, or food; exposure to "something" that one should not have contact with in pregnancy) impact the developing embryo. Sometimes, there just is no answer.

How Often Does it Happen?
The short answer: a lot. The longer answer, according to The Hope Exchange (a website providing help after pregnancy loss), is that as many as 25-33% of all known pregnancies end in miscarriage, and up to 40% of all (including pre-positive pregnancy test) pregnancies end in miscarriage. Most of these pregnancies are lost in the first trimester, though some pregnancies are lost after 20 weeks (called stillbirth beginning at 20 weeks).

Am I Normal?
This is a hard question. My personal philosophy is that "normal" is a setting on the washing machine. But in the grander scheme of things, miscarriage is an unfortunately common experience. Almost 20% of the adult population has experienced the loss of a child (either in utero, or at some time in their lives). About 80% of miscarriages are one-time occurrences. Most people who experience a miscarriage only experience it once. Health care providers only conduct testing after three consecutive miscarriages (unless there is some indication in your medical history to check for problems before that).

What Should I Do if My Pregnancy isn't Viable?
There are three options on how to manage a pending miscarriage from the healthcare perspective.
1. Watch and wait. This is the fancy medical term for "natural" miscarriage. If the gestation stops progressing early (no more than about 7-8 weeks), even if not detected until later in expected pregnancy duration, the body will begin to expel the tissue on its own. 90% of miscarriages using this procedure will effectively end in complete miscarriage (e.g., all pregnancy-related tissue is expelled).
2. Medicine. Taking misoprostol (brand name: Cytotek) will expedite the miscarriage process. The body would still expel the tissue, but the process would occur faster (over a matter of hours, rather than days). Expect to have diarrhea, substantially more cramping than a natural miscarriage, and possibly more bleeding. If the watch and wait method has ended in incomplete miscarriage (e.g., some tissue from the pregnancy remains in the body), this medicine is used to "help" the process along.
3. D & C. Dilation and Curettage (or, more commonly, Dilation and Suction) is a very common treatment of miscarriage that works 100% of the time, no matter what type of miscarriage you are having. This is a medical intervention that involves sedation with anesthesia, local anesthetizing of the cervix, artificial dilation of the cervix, and suction of all tissue from the uterus.

Wait, there are TYPES of Miscarriage?
Yes, there are a few types. Embryonic Demise or Blighted Ovum is when the pregnancy has started but stops progressing for some reason. This usually happens very early in pregnancy. Incompetent Cervix is when a pregnancy is affected later (usually in second or third trimester) because the cervix is weak and begins to open due to the pressure from a growing baby. These happen in 1 of 100 pregnancies, and usually only if the cervix has been affected in some way by previous surgery, a previous traumatic birth (excessive tearing of the cervix), malformed uterus, or other defect. Anembryonic or Empty Sac pregnancy is when the pregnancy begins and a gestational sac is formed, but no embryo develops at all. These types of pregnancies usually require either the medicine or D &C approach to managing the miscarriage because the body will only naturally expel the tissue about 2/3 of the time. It may also be helpful to know that the medical term for miscarriage is Spontaneous Abortion. Abortion when it relates to pregnancy means "stopping the progression of pregnancy," and spontaneous means "it just sort of happened."

How do I Deal with Miscarriage?
This is a very personal thing. Miscarriage results in grief for many families. If it is your friend who is experiencing a miscarriage, imagine that she is experiencing the death of her child. Because she is. The pain and grief is unimaginable. And because of that, she may be acting angry, sad, indifferent, or any combination. Grief is funny that way. Most often, people feel angry and direct it at anything and anyone who happens to be nearby. Do not take this personally. If she's acting like she's in another world somewhere (this is called dissociation), she probably is. The real world keeps going on as if nothing happened. Her internal world is a mess of emotions and pain, and she can't really function there either. So she might "go away" for a while to help herself function in the real world and not necessarily address the internal mess. That's okay for a little while, but ultimately, we all have to face that grief. Otherwise, we might forget our way back to those emotions, and they'll keep poking their way into our lives in situations that are totally inappropriate. Like making us lash out at our spouses or children or friends.

Dealing with miscarriage is a challenge because people don't talk about it. Nobody knows what to say. Nobody has the right words, so they say nothing. Or they change the subject. Or they pretend nothing's wrong because they think that might be helpful. In actuality, it sends the message that our pain is insignificant, or that we can somehow be able to move on faster than we would if grieving a person we'd actually met. But what so many fail to realize, is that parents have made plans, have hopes and dreams, and maybe even imagine they know the little life they've created. They love the child they haven't met yet. And when a miscarriage happens, all of those things become meaningless or lost. They become part of the grief. And in some way, there's a darkening of hope for the future because their new little future is no more. They have to find out what their life is again. Now that it's missing a very special someone they've dreamed about, maybe before that someone was even conceived.

Sometimes, people rely on their faith to help them through this difficult time. Sometimes, people have crises of faith and blame their Deity(ies) for what has happened. Sometimes, people rely on friends who have had this experience. Sometimes, people become angry at friends because nobody has experienced the pain they feel right now. Sometimes, people quietly endure the grieving process. Sometimes, people choose to seek help from a therapist. I have chosen the latter because, again due to my personal philosophy, I am a therapist and cannot sell something I wouldn't choose to buy for myself. Therapy allows me to be angry, sad, afraid, confused, and whatever else I go through, without judgment. And therapy allows me to find the answers I seek within myself. Because they are there, even if I can't see them right now.

The Yacht Club

Evidently, my children are boaters. One small problem.... we do not, nor can we afford to, own a boat. The pictured boat belongs to my brother-in-law and his father. While a modest income can certainly afford a boat (we grew up with one), the additional costs of maintaining, storing, and using one can be far outside the limits. In my mind, I would imagine the only people who have boats and use them more than once or twice a year are either (a) fishermen or (b) people who use the names of seasons as verbs (e.g., "We shall summer in New England this year").

Siblings on Uncle's boat 

Meanwhile, the babies are no babies. My, how they've grown! My girl is now a five-year-old who has completed a year of pre-K at a lovely school in our area. She moves on to kindergarten this fall. Her aunt (wife of the boat-owner, and my sister) is pregnant. So, now my darling daughter pretends to be pregnant as well. She has no idea how much the prospect of her becoming pregnant (like EVER) terrifies me. Of course, someday this fear will vanish, I'm sure. There will come a time when grandchildren will seem like fun (rather than the death knell of my youth).

Five years old - the Skipper

We experienced our first (ever) fracture. During soccer, she had an avulsion fracture of her right fibula after tripping over a soccer ball. Never mind that it occurred because I might have allowed her to wear inappropriate shoes. She's taking it well, and is allowed to walk around with an air-cast. However, I should clarify that this child does not walk. She hops. She skips. She jumps, dips, dives, and does pretty much everything her doctor said not to do. And why not? She's five.

Two years old - the First Mate

My boy is two, and not the terrible kind. I'm convinced two is "terrific" and three is the "terrible" one. We'll see, come this time next year. Potty-training will be on the agenda for this year (hopefully this summer). He already senses the bodily urge and knows how to use the toilet, but his interest waxes and wanes (or, more appropriate to the theme, ebbs and flows like the tides).

He speaks rather well, but we've learned that his adenoids are enlarged and may be impacting his speech and breathing. While he gets sufficient oxygen, his sleep is likely impacted from snoring, and his speech is affected by the poor airflow during specific lip and mouth movements. We have a follow-up otolaryngology (ENT) consultation to determine if he will need surgery. While I try to wrap my mind around surgery on my baby boy, I have heard from other moms whose children managed to survive adenoidectomies.

Finally, we consider for a moment the possibility of expanding our family. What might that do to our great dynamic? How will the first two react to a third? They each have selected a same-sex sibling, as well as a name - the daughter wishes for a sister named Daisy Sunrose, and the son wishes for a brother with the same name as he has (because it is SO EPIC). And then, there are the financial considerations of how to manage upgrading a car (a must, to fit in a third child seat), where we'd all sleep, and how to pay for child care (which already costs more than our mortgage). So much for the yacht club.

Intervention

Wow. It's been nearly one year to the DAY since the last post. Two little kids with their two parents in graduate school is no joke.

This (year's) post title, "Intervention," seems appropriate on multiple levels. When life gets so busy that you don't have time to stop and.... I dunno...breathe the oxygen, it's time for someone to knock you upside the head and tell you to slow down for a second. While we spend the majority of our time running around like the White Rabbit from Alice in Wonderland, we do actually get a few moments to pretend we're a "normal" family. Of course, I use the word normal loosely. I firmly believe it's a setting on your washing machine and nothing more.

Today was one of those days we got to be somewhat normal. When I titled the post "Intervention," the intent was a little different than the aforementioned. My children, ages five and two, have now gotten to the wonderful age where arguments occur. Maybe even brawls. Today's example was when the 2-year-old boy asked (in the sweetest, most polite manner I've ever heard) his big sister if he could play with one of her toys, she SCREAMED in wild protest, "NO!!! NO!!! NO!!!" To which, the boy cried huge, devastating crocodile tears.

No one was harmed in this exchange. Physically, anyway. I often wonder as a parent when I should intervene. I wanted to do it today, but I did not, and here's why:

I have a rule I use with the 5-year-old on tattling. She is REALLY bad about doing it ALL the time. She doesn't get the concept that, "Nobody likes a snitch." Instead, I've resorted to providing clear-cut examples of when it is appropriate to "snitch" and when it is not. Bottom line: it's okay to tattle when someone is in danger or if someone's property is in danger. I'd like to take credit, but my sister let me borrow a book called Help Me Be Good: Tattling (one in a great series, actually) that helped a lot.

Anyway, I figured the same rules should apply to me. If nobody is in danger, and nobody's stuff is in danger, I should really let them work it out. They need to problem-solve on their own, and they'll never get practice if I keep breaking it up all the time. While I certainly wouldn't just let them go wild, I think they are not in the right mindset to accept a "teaching moment" (read: a lecture on the proper way to negotiate) when they're already in the throes of a knock-down, drag-out tumble over a toy.

The husband and I try our best to demonstrate clear examples of how to problem-solve as a team and negotiate the terms of a compromise. Additionally, there are plenty of opportunities to observe other kids or even use television (I know, I know... the evil box that sits in the living room babysitting other people's kids) to show where the actors (or cartoons) could have done something different.

Besides, I'm tired of screaming, "Knock it off!" from the top of the stairs.