Hello 2017!

2016...a year I am looking forward to putting in the history books.

For me it is marked by loss -- very personal loss.

The world is not completely cruel -- along with the loss I had some gains...I was lucky enough to gain two beautiful new nephews. I am loving watching them grow.

But I do hope 2017 brings more gains than losses. I am entering 2017 with hope -- and hope you will, too.

But 2016...smell ya later!

Wishing you all a very happy and safe New Year.

The Small Percentage

20% of known pregnancies become non-viable/end in miscarriage.
2% of known pregnancies end in missed miscarriage (the body does not expel the fetus, even after non-viability)
30% of D&Cs from a missed miscarriage lead to Asherman's Syndrome (uterine scarring)
23.5% of women over 35 diagnosed with Asherman's are able to give birth.

What does this all mean?

My doctor was convinced I would get pregnant very quickly once I got my period. Frankly, I thought I would, too! But when that period never came...we started to get concerned. We waited a bit...just in case my body was taking its time getting back on track. When after over two months came and went, it was time to take things into my own hands and push for further diagnosis. (tip: become your own advocate. Push when you think something is wrong.) 

First I had a sonogram -- luckily we had this scheduled because my doc thought she saw a strange blood vessel and wanted to get it checked. That didn't tell us much, but the sonogram doc recommended that I have a sonohysterograph. Sounds intimidating, no? (tip: take a few ibuprofen and be prepared for some cramping. It is uncomfortable but not painful) The doctor became concerned when she could barely get the fluid in. I became concerned when she said that meant there was some scarring...and the call from my ob-gyn further confirmed this and suggested I see a specialist.

Off I went to a specialist in minimally invasive gynecological surgery. Full of hope, I watched as he looked over my results. I listened as he talked about my uterine scarring, also known as Asherman's syndrome, and went over how he would perform the surgery, an operative hysteroscopy, and the risks involved. And a few days later, there I was in the operating room, and shortly thereafter, in the recovery room. The scarring was extensive, he had gotten most of it, but I needed to have one more to finish it off. In the meantime, I would take estrogen to help build my endometrial lining, and progesterone to help get my body to have a period.

Knowing what I know now...not getting that period would have been a sign that something else was wrong. I didn't know that then, though...what I did know was that I had a short window in which to have this surgery before I, once again, had to travel for work. I adjusted my schedule, and on our first anniversary, 9 May 2016, I went in for my second hysteroscopy.

I will not forget the look on my doctor's face when he told me that while he had gotten all the scarring, my endometrial lining was less than optimal; in fact, it was almost non-existent. After a month of estrogen, it should have been nice and thick...and it wasn't. I cried a lot that day. J felt sad that day. To me, that news was harder than hearing our pregnancy was non-viable. It was harder than the D&C procedure that had likely caused the scarring. The following day when my ob-gyn called to tell me to say she'd never seen anything like this, reminded me she had stopped the D&C so she wouldn't go too deep, and that I would need to consider other options, I cried more.

In a weird way...it felt like the first time I had felt something visceral since my dad passed away. The sorrow was deep, my cried more like bellows...I wonder what the person in the hotel next to me thought. I quickly made an appointment with the fertility specialist, but that day, I started grieving. I had lost my ability to carry a child.

We went to the specialist -- tried a few more rounds of estrogen. We tested my eggs -- there were a lot and they were good. My body was absorbing the estrogen well, but still my lining didn't exist. The cruel irony didn't escape me...I thought it would be my age that would hinder our ability to have kids, but no, I am fertile Myrtle but with no place to put 'em! I listened and cried as two different fertility docs told me to consider surrogacy. I grieved that my body couldn't do what it was supposed to.

And I was angry. Angry that my body couldn't do what it was supposed to. That through no fault of my own, my fertility was taken from me. I was angry that my body felt terrible -- bloated and crampy -- and I got no relief. And I was sad that J's chance for a bio child was taken from him, too. That took a long time to get past.

During this time I also suddenly lost my uncle, which, in a weird way, helped make our next step decision a bit easier.

So what does this all mean?

It means I had a lot of bad luck in the fertility department. How I ended up in this small percentage, I don't know. But I did.

This wasn't where I expected life to take us. I allowed myself to grieve and be sad. This was very important. I tried not to be too hard on myself -- which in itself was tough. Once I allowed for all of that...I was able to focus on our next journey.

When It's Finally Over

When your pregnancy is found to be non-viable, you have a few choices:
1. Wait for it to pass naturally
2. Take medication that causes your body to abort
3. Have a medical procedure
4. Drink (well...that is an adjunct to all of those!)

I had a work trip planned about two weeks after we found out. I didn't have the luxury of time, but also, my body wasn't doing a great job of miscarrying on its own. I decided first to take medication.

This was the only time I slowed down slightly from work. I relaxed, took the medication, and waited for the cramping to come. I waited...and waited...and waited...There was one moment when I thought, yes, this is it. But a small clot passed and a small cramp, and that was it.

This gave me a lot of time to think and get angry.
Why was my body behaving in such a way?!
Could it not do anything right?

This did no good, I could not will my body to pass this mass of tissue that was now tricking my body into thinking it was still pregnant. Until I could let it go, I would remain tired. My boobs would remain swollen. My hormones would remain a bit out of whack.

I remained hopeful throughout the weekend that the medicine would take care of things. Alas, it was not to be. My body -- she is a stubborn one! We had a contingency plan with the doctor should this happen, and that was to get a dilation and curettage (D&C) early in the week. This carried with it some risk, but I was told that it was minor and the best way, at this point, to complete the miscarriage.

I have always been a strong advocate for a woman's right to choose, and for safe access when a woman chooses to end her pregnancy. After going through the procedure myself, this need to safe access resonates even more so. This is not a sophisticated procedure -- you have strong pain medication, and the doctor sticks a suction tube up your lady bits and scrapes around. Without a sterile environment, by a professional who knows what they are doing, there is a huge risk for infection or worse.

At any rate, my doctor and I chit chatted while I tried to stay brave throughout the procedure. I was super grateful for my high pain tolerance...though I did ask them to pump up the drugs at one point. And then, just as quickly as it had all started, it was over.

The procedure. My pregnancy. All officially over.

It was pretty unceremonious, and while they required that someone pick me up, I could have just as easily driven myself home.

Which I should have...because to add insult to injury, I ended up getting a parking ticket after leaving my car parked nearby overnight.

Sicily: Seaside in Cefalu

Cefalu by Night

After a harrowing journey to get there, Cefalu was a very welcome sight!

It is a small resort town about thirty minutes from Palermo. Quite a bit of the town is off limits to cars -- though the rules are rather ignored, including by us! It was a bit easy to get lost, and ignore the signs, and no one seemed to care much...but be warned.

Cefalu was a darling beach town, and a nice change from the inland mountainous area where we'd spent the first few days. We parked the car, checked into the hotel, and meandered around town to grab a drink and decompress from the drive. We found ourselves in this lovely little town square at the base of a church, and since it was a Friday, there was a wedding going on. There was also a very happy happy hour, where we enjoyed prosecco and spritzes for a while, and maybe a bite or two.

There is a hike you can do that will take you above the town -- we chose not to do that. We chose instead to have a bit of vino on the roof of our hotel and watch the sunset, then to grab some food. Cefalu is small enough that you can walk from end to end during an evening passeggiata. 

The next morning we decided to take our time getting into Palermo, and to enjoy the Tyrrhenian Sea. There is a public beach, but your best bet is to spend a few Euro and rent a beach chair. We chose to stay right in the middle of Cefalu -- there are beaches a little further out, as well. We bought a towel in one of the shops (which came in handy later!), and rented chairs. Ours were probably about 10E a piece for a few hours of lounging. They have umbrellas should the sun get too intense, and most have a bar and some food, and will come to your chair and take/bring your order.

This was a fun, relaxing part of the trip -- it was interesting to watch all the beach goers from around the world. Like many places, there were "vendors" trying to sell their junk as we tried to relax; most of the time they were asked to leave by the beach chair company.

I'd highly recommend a day and night in Cefalu during your Sicily trip. Sicily is an overwhelming place -- the craziness of rural driving and the wildness of the cities really earn you a day or two of relaxation.

Why We Shared

On this Thanksgiving Day, I am thankful for what I got to experience over this past year. I got to experience a tremendous amount of love, support, and patience (including from myself!) and for that I am grateful.

It's been my experience that many women, and their partners if they have one, choose not to share the news of their pregnancy until they are at least out of the first trimester. The thinking is that you wait until you are in the "safe zone."

But...there really is no 100% safe zone. People experience losses at all stages of pregnancy, and there is one common thread through it all -- we all need support.

Keeping a pregnancy secret is really, really hard. Especially when you find out right at the start of the holiday season...there are a lot of parties, and a lot of people watching every thing you put into your mouth. I was very tired, as well, so trying to stay up late enough to even go to a party was difficult (my apologies to everyone whose party I flaked on). Even without that, you are excited and scared and need to shout it from the roof tops.

J & I discussed quite a bit whether or not we should tell everyone. We knew our families would be together on Christmas, and, after all, the doctor had told us we could. If we shared early, we figured, the worst that could happen was we'd have to go back and tell people it didn't work out.

So we shared.

And it didn't work out.

We were so glad we shared. I will never forget the smile on my mom's face when we told her. I will never forget her tearing up when my nephew walked out in front of the family with a "Big Brother" shirt on Christmas Eve (yup, my brother & sister-in-law were also pregnant, due two weeks or so before we would have been)...and I will really never forget the whoops and tears, so loud my ears were ringing, when we lifted my nephew's shirt to reveal a sign that said "and big cousin." It's now made even more special because I'd not seen a smile that big on my Uncle B's face in a while; he is no longer of this earth, and I carry that smile with me. I will never forget J's mom needing to hand the phone off because she was so happy, the texts we got from his family, and his little sister being so excited when we called her. I wouldn't trade those memories for anything.

But we are mostly glad because when all was said and done, we needed their support. Some people were uncomfortable, some didn't know what to say, but because we'd shared, they were in our corner, they were there to hold us up as we wobbled down this road. And we didn't have to hide or be secretive when we had our bad days. No one questioned when I had to beg out of a party because of a slight emotional breakdown on the way. We could talk about it -- both me with my friends and, equally as important, J with his friends. And many people let us know that they, too, had been through this (but hadn't told anyone).

There is a sense of shame that many of us carry -- especially with women -- when a pregnancy becomes non-viable. Because we don't talk about it, the shame is compounded because we feel abnormal. We need to talk about it, because we are not abnormal, we did nothing wrong, and we are not alone...it is estimated 20-30% of pregnancies become non-viable, that is one out of every three people.

I am not suggesting we introduce ourselves to strangers by leading with, "Hi, I'm Annie, and I have had a non-viable pregnancy." But I am hopeful that we stop hiding. That we stop waiting until another friend experiences the same and then we tell them. And that we stop being uncomfortable when a person talks about their own experience.

It is not an easy thing, but it is not a rare thing. And support can truly make a huge amount of difference.

Ok, let's eat.