Wednesday, September 28, 2011
Pathology
I've come to despise the word fetus. I got Nathan's pathology report in the mail yesterday. I was running late yesterday so I grabbed the mail and shoved it into my lunch box. When I got to work, I started reading the mail while I was on my lunch break. I didn't realize that's what it was until I opened it and started reading. I couldn't even get through the first page before I had to put it away. That's what he is referred to on it... not a baby, not Nathan... "the fetus". I don't even know that I want to read it now.
Tuesday, September 27, 2011
Hope
I came across a blog hop... something I'd never heard of until now. I took a huge step when I shared Nathan's donation project's page publicly. I'm a new blogger and haven't actually shared this page with anyone. It's been my safe place. A place to vent without caring about anyone's opinion or feelings. So... as you can see, this is an even bigger step. Nika's post about sharing stories really helped me decide to jump. http://rebuildingabrokenheart.blogspot.com/2011/09/sharing-stories.html (She gave me permission to share her story.)
The blog hop is about what has brought you hope here lately. I read through the other blog posts and have been pondering this for a couple days now. What has brought me hope lately?
(About 10 minutes later... sitting and staring at the screen.) Okay... this is hard. Harder than I thought. You see... I'm still in a place of trying to figure out exactly what the heck has happened to my life. The mirror has been shattered and I'm still trying to put the pieces back together. I know the cracks will be there and it will always be broken... but maybe I can tape the pieces back together. I don't need to have a perfect mirror... I just want to be able to see again.
I think the thing that has brought me the most hope recently is Nathan's project. I've had so many people tell me how strong I am... especially for wanting to do something so soon after his death. I don't really have an answer, other than, I don't know what else to do. I don't have a choice. Life goes on and the sun comes up whether I want it to or not. I have a husband and another son here who need me. It doesn't matter whether its fair or not... I have to learn how to survive without Nathan here on Earth.
I now have something… a reason to keep going, a purpose. Of course, I have my husband and older son but this project gives me something that ties me to Nathan. It is like holding onto a small piece of him. I don't understand why he isn't here with me and I don't think I ever will. I just know that I can't go back and change anything with my situation but if I can hopefully help another parent avoid the regrets that I have; then perhaps it will make me feel like Nathan's life was important to someone other than me. I can't "mother him" or do anything to show my love for him… so I'll "mother" and pour my love and energy into his project.
I've met SO many people over the last 2 months. People that I would have never met if he were still inside me. I have a goal... a plan... a hope... that someone, besides me, will know how special his short life was. He has taught me so much about love, life, myself... and more importantly, about God. I've always believed in God but never have I felt His presence more than I do now. For that, I will be forever thankful for Nathan. I will praise God for the four short months that he let Nathan grow inside of me. He may have only been in my tummy for four months, but he will live in my heart until I take my last breath and join him.
The blog hop is about what has brought you hope here lately. I read through the other blog posts and have been pondering this for a couple days now. What has brought me hope lately?
(About 10 minutes later... sitting and staring at the screen.) Okay... this is hard. Harder than I thought. You see... I'm still in a place of trying to figure out exactly what the heck has happened to my life. The mirror has been shattered and I'm still trying to put the pieces back together. I know the cracks will be there and it will always be broken... but maybe I can tape the pieces back together. I don't need to have a perfect mirror... I just want to be able to see again.
I think the thing that has brought me the most hope recently is Nathan's project. I've had so many people tell me how strong I am... especially for wanting to do something so soon after his death. I don't really have an answer, other than, I don't know what else to do. I don't have a choice. Life goes on and the sun comes up whether I want it to or not. I have a husband and another son here who need me. It doesn't matter whether its fair or not... I have to learn how to survive without Nathan here on Earth.
I now have something… a reason to keep going, a purpose. Of course, I have my husband and older son but this project gives me something that ties me to Nathan. It is like holding onto a small piece of him. I don't understand why he isn't here with me and I don't think I ever will. I just know that I can't go back and change anything with my situation but if I can hopefully help another parent avoid the regrets that I have; then perhaps it will make me feel like Nathan's life was important to someone other than me. I can't "mother him" or do anything to show my love for him… so I'll "mother" and pour my love and energy into his project.
I've met SO many people over the last 2 months. People that I would have never met if he were still inside me. I have a goal... a plan... a hope... that someone, besides me, will know how special his short life was. He has taught me so much about love, life, myself... and more importantly, about God. I've always believed in God but never have I felt His presence more than I do now. For that, I will be forever thankful for Nathan. I will praise God for the four short months that he let Nathan grow inside of me. He may have only been in my tummy for four months, but he will live in my heart until I take my last breath and join him.
Wednesday, September 21, 2011
2 Months
I can't believe it's been 2 months since Nathan's death. I'm sad just thinking about it. It feels like I'm on an escalator. I can still see him, as I'm looking back... but the escalator (each day) is taking me farther from where he is. (Does that make sense?)
Nathan,
I miss you, baby boy. I love you and wish so badly that you were here with me... still in my tummy. I wish that I only had to wait 15 more weeks to see you. I would wait patiently... because the wait would be worth it. I laid in bed last night and closed my eyes, trying to remember each part of you. You are slowly fading from my memory... well, not you... but the details of you. I hate my brain for failing me. I'm trying so hard to hold on to as much as I can. I'm trying sweetie... I really am.
Love,
Mommy
Sunday, September 18, 2011
Hospital Appointment
I just realized that I didn't talk about the visit to the hospital. I saw the maternity floor coordinator on Thursday about our project, You are my Child. I guess it went pretty good. She is supposed to find out some more information for me. There were a few questions that she didn't have an answer to. Of course, I was kinda nervous and totally blotched the entire conversation (or that's how I felt). I kept trying to remind myself that I was there to be a source of help for the other parents... not to bash them (the hospital) and tell them about all the regrets I left with. (Although, I did share a few with her.)
She said that she thought they had an organization that donated clothing and blankets years ago but she couldn't remember if or why they stopped. She gave me some information about the statistics (numbers) of losses they have. Of course, it kinda hurt a little when she said that they only count the babies born in the maternity suite. Basically, cases like mine (which are apparently rare) aren't counted because we deliver on the maternity floor in a regular room, not in the maternity suite. Last year, they had 18 "fetal losses" in the maternity suite. This year, as of the end of August, they've already had 17. Those numbers don't reflect babies who are miscarried and delivered via D&C or like me, outside of the maternity suite.
That kinda sucks because the earlier losses are the ones we are primarily targeting. Not to say the later, 3rd trimester losses, aren't as important. It's just that more people/organizations/hospitals are geared towards helping those families already. Those families leave with footprints and keepsakes. When I showed her one of the memory boxes, she asked about the ruler in it. I told her that I didn't know the procedure for different gestations, but that Nathan wasn't measured. She said, "There isn't a reason to. We have no statistical purpose to." I had to compose myself for a minute before I continued because frankly, it pissed me off. I told her that I measured Nathan with my hand and that was the only reason I had a measurement for him. Parents like me, leave with so little. When at all possible, we want the same things that a parent of a stillborn or full-term baby would get. To be able to leave with an outfit or blanket our child touched... to have an accurate, medical weight and length... to have a picture... to have footprints... those things are just as important and priceless to parents of a 2nd trimester loss.
I did get an answer about the footprints, and why we weren't able to get any of Nathan. It made me actually feel even better about my nurse. Knowing that the chances were slim to none, she still tried anyway. That warms my heart and lets me know that she really did care. Anyway, she told me that I was right and that the main reason was, not being able to get him dry enough and that at that gestation, they normally don't have enough ridges in their feet to pick up the ink. I didn't think about it until after I had left, but a girl on my support board lost her daughter about a week before me. Our babies were only a couple days different in gestation and she got footprints. I need to ask her and see if her hospital has a different protocol or if there is a different kind of ink or something that they use.
That understanding also shot the clay molds out of the water. She said since the babies limbs are so fragile and brittle, they aren't able to apply enough pressure to the baby's joints to get an indentation into the clay. It would be pretty useless to put them in the boxes for the smaller babies.
I had asked about the point in which they can start dressing the babies, without much fear of bruising them. She told me 25-30 weeks. I've seen smaller babies dressed so I was kinda confused by the information I've been getting from different sources. I realize the goal is to handle them as little as possible... so the outfits we're looking to make are very minimal, as far as having to manipulate babies in them. I guess I need to look more into this.
After talking to my therapist that afternoon, she mentioned that it might be a better idea to get with local OB offices and find out about distributing through them, since the hospitals don't keep realistic, accurate statistics of ALL losses. That way families have all these resources BEFORE they go to the hospital. Once they receive the devastating news, they can begin to view the resources and have a chance to digest what their choices are beforehand. So many life changing questions are asked right there in the hospital. What the staff doesn't get... is the fact that most of the time you aren't really there to make those decisions. Your body is but your mind and emotions are in shock. If we decide to go that route, we'll still donate to the hospital for the families who come in through the ER or who find out there, that their baby is no longer living or won't survive.
Lots to think about and work through. I'm still excited though. My hope is that we're opening the door for earlier losses to receive the same care, support and options (when possible) as the later losses. There is nothing that will make the situation better or easier but I pray that no parent has to leave the hospital with the pain and regrets I did. I hope that our resources will help them gain a positive, meaningful goodbye with their baby and they are able to leave with keepsakes... tangible proof that their baby existed.
She said that she thought they had an organization that donated clothing and blankets years ago but she couldn't remember if or why they stopped. She gave me some information about the statistics (numbers) of losses they have. Of course, it kinda hurt a little when she said that they only count the babies born in the maternity suite. Basically, cases like mine (which are apparently rare) aren't counted because we deliver on the maternity floor in a regular room, not in the maternity suite. Last year, they had 18 "fetal losses" in the maternity suite. This year, as of the end of August, they've already had 17. Those numbers don't reflect babies who are miscarried and delivered via D&C or like me, outside of the maternity suite.
That kinda sucks because the earlier losses are the ones we are primarily targeting. Not to say the later, 3rd trimester losses, aren't as important. It's just that more people/organizations/hospitals are geared towards helping those families already. Those families leave with footprints and keepsakes. When I showed her one of the memory boxes, she asked about the ruler in it. I told her that I didn't know the procedure for different gestations, but that Nathan wasn't measured. She said, "There isn't a reason to. We have no statistical purpose to." I had to compose myself for a minute before I continued because frankly, it pissed me off. I told her that I measured Nathan with my hand and that was the only reason I had a measurement for him. Parents like me, leave with so little. When at all possible, we want the same things that a parent of a stillborn or full-term baby would get. To be able to leave with an outfit or blanket our child touched... to have an accurate, medical weight and length... to have a picture... to have footprints... those things are just as important and priceless to parents of a 2nd trimester loss.
I did get an answer about the footprints, and why we weren't able to get any of Nathan. It made me actually feel even better about my nurse. Knowing that the chances were slim to none, she still tried anyway. That warms my heart and lets me know that she really did care. Anyway, she told me that I was right and that the main reason was, not being able to get him dry enough and that at that gestation, they normally don't have enough ridges in their feet to pick up the ink. I didn't think about it until after I had left, but a girl on my support board lost her daughter about a week before me. Our babies were only a couple days different in gestation and she got footprints. I need to ask her and see if her hospital has a different protocol or if there is a different kind of ink or something that they use.
That understanding also shot the clay molds out of the water. She said since the babies limbs are so fragile and brittle, they aren't able to apply enough pressure to the baby's joints to get an indentation into the clay. It would be pretty useless to put them in the boxes for the smaller babies.
I had asked about the point in which they can start dressing the babies, without much fear of bruising them. She told me 25-30 weeks. I've seen smaller babies dressed so I was kinda confused by the information I've been getting from different sources. I realize the goal is to handle them as little as possible... so the outfits we're looking to make are very minimal, as far as having to manipulate babies in them. I guess I need to look more into this.
After talking to my therapist that afternoon, she mentioned that it might be a better idea to get with local OB offices and find out about distributing through them, since the hospitals don't keep realistic, accurate statistics of ALL losses. That way families have all these resources BEFORE they go to the hospital. Once they receive the devastating news, they can begin to view the resources and have a chance to digest what their choices are beforehand. So many life changing questions are asked right there in the hospital. What the staff doesn't get... is the fact that most of the time you aren't really there to make those decisions. Your body is but your mind and emotions are in shock. If we decide to go that route, we'll still donate to the hospital for the families who come in through the ER or who find out there, that their baby is no longer living or won't survive.
Lots to think about and work through. I'm still excited though. My hope is that we're opening the door for earlier losses to receive the same care, support and options (when possible) as the later losses. There is nothing that will make the situation better or easier but I pray that no parent has to leave the hospital with the pain and regrets I did. I hope that our resources will help them gain a positive, meaningful goodbye with their baby and they are able to leave with keepsakes... tangible proof that their baby existed.
Questions
I was searching online tonight for loss specific sites (Cord accidents, Trisomy 18, etc) to add to YAMC's site. I came across this article. Its pretty long but as I read it... now, it's got me wondering. Was Nathan's cause of death really a cord accident? The way I read the article, cord accidents in the 2nd trimester are almost unheard of. There is almost always another cause. I know it won't change anything but I think I'm going to show my doctor this and ask to see my medical records from the delivery. If there is a chance that anything that happened, could be repeated in a future pregnancy... I want to know. I don't get a death certificate or legal cause of death but I still want to know what happened. Sometimes the internet is a dangerous place. It would so much easier to hide and not have all this information... just be secluded in my own, naive little world.
Was my doctor right in diagnosing a cord accident? by Carolyn Salafia, MD, Ph.D.
A "cord accident" is a very non-specific diagnosis that just means "something" happened to the cord. That "something" could be anything from a cord being wrapped around the baby's neck, to a cord prolapse, to umbilical blood vessel rupture. Cord problems are real problems, especially at term but commonly pathologists believe that a normal cord has enough built-in protection to save itself UNLESS there is some other kind of problem making it harder for the cord to function properly. That's why we look closely at the placenta to determine what might have caused the cord to fail. Although true cord accidents do occur in the third trimester, I have no recollection of ever coming to the conclusion of a pure cord accident in the second trimester when the amniotic fluid volume was normal, and the placenta and cord were healthy. Even in the third trimester I commonly find that a cord accident was a final event and not the cause of the problem that led to the baby's death. I generally conclude that the cord was put at risk because of another circumstance. In future pregnancies many of those circumstances wouldn't necessarily recur as a cord accident. Those maternal problems could manifest themselves in any one of a number of ways such as growth restriction, fetal death, preeclampsia, or preterm birth. That's why it's important for a pathologist to examine your placenta to determine exactly what caused your cord to fail.
To understand why a true cord accident--whereby the cord gets trapped or fails without some other process causing it to fail--is rare it helps to understand how the umbilical cord functions. The cord has two arteries wrapped around a vein. That means it has two outflow tracts and one inflow tract, centimeters at a remove from the baby's itsy-bitsy heart. The force of that little baby's hearbeat has to get blood all the way down the cord through a capillary bed where flow is necessarily very slow and then all the way back up the vein. The idea people have is that the only way Mother Nature allowed us to evolve such a stupid lifeline is because the cord is built to be able rescue itself most of the time.
To help protect itself, the cord has a substance called Wharton's Jelly around the blood vessels. It takes some force to actually move Wharton's Jelly but after the force is applied, the jelly will move and assume a new position. That means that if the cord is compressed it will remain where it is until the pressure becomes great. Then the Wharton's Jelly will cause it to move into a safer position.
In addition, the umbilical cord is covered by a skin that allows the cord to slip and slide at term even when there's not a whole lot of amniotic fluid, just like your intestines slip and slide in your belly. In fact, the cord is so slippery that when they're trying to encourage the placenta to be born, obstetricians may have to wrap the cord around their hands several times in order to get a good grip on it. If you have adequate fluid volume and a healthy cord I find it hard to understand how a cord could get wrapped several times around a baby's neck and stick there during the second trimester. I find it a lot easier to imagine how a floppy lifeless cord could drape itself around the neck of a child who has died and may be rotating in utero due to maternal positioning and gravity. Then, as the baby is delivered the cord would be pulled and tightened in its position as the baby descends and the placenta is retained attached to the uterine wall. But if there's enough amniotic fluid in the second trimester I can't see how the cord can get trapped. If a cord does get trapped in the second trimester with even a respectable amount of amniotic fluid then I have to worry about abnormal things in the amniotic fluid space that would cause epithelial erosion, like blood.
Since the cord is built to rescue itself under most circumstances, when a "cord accident" is diagnosed by an obstetrician, a reproductive pathologist will look for problems that might have increased the cord's vulnerability. Some of the questions I ask as I examine the placenta are: Was the placenta damaged so that the baby's heart would have had to work harder to pump blood through the placenta? Is there abnormal inflammation? Are there infarcts? Is the cord inserted on the wrong place, i.e. on the membranes instead of on the chorionic plate? Are the blood vessels abnormally straight? (In a normal cord the two arteries wrap around the vein and the pulsations of the artery help milk blood back up the vein. Some ultrasound studies have suggested that when there is not a helical coiling of the blood vessels, the straightness of the vessels is associated with a greater risk of problems. Presumably the idea is that if the arteries aren't lending their support to the vein, there might be an abnormality in how well the cord is functioning and it may be closer to a threshold where it doesn't rescue itself.)
At times (it's quite uncommon, and far less often than my clinician friends think it might be a cord accident!) I do diagnose a true cord accident in the third trimester. These would be:
1. A knot in the cord.
2. Spontaneous cord vessel rupture.
3. Nuccal cord. This is the medical term for a cord being wrapped around the baby's neck.
4. Cord prolapse. This is when the cord precedes the baby out of the uterus.
Also sometimes there is a problem with water flow and the umbilical cord Wharton's Jelly possibly isn't well hydrated. Or there may be something "bad" in the amniotic fluid space--like meconium or blood--so that the umbilical cord epithelium is eroded. Or there may be something abnormal in the organization of the arteries so that maybe the arteries don't help milk blood back along the vein the way they ought to. Then I would diagnose a cord accident.
However more commonly I find other issues that probably caused the cord to fail. There are more common reasons for the cord to get caught and have an accident; the frequency of each really varies with different hospitals and different groups of people. The most frequent causes of cord failure are:
1. Abnormal amniotic fluid volume. In the second and third trimesters amniotic fluid is mainly made up of the baby's urine. Normal kidneys can change their level of urine production depending on how much blood flow comes to them. Blood flow will be shunted away from the kidneys to more vital organs like the heart and the brain if there is a problem with oxygen delivery. If amniotic fluid volume drops off steeply I have to start wondering if there's some reason why fetal urine production is being reduced. If the placenta is insufficient or if the baby perceives low oxygen levels in its tissues, it will start shunting blood away from its kidneys to spare its vital organs. That shunting away will decrease the amount of blood that's filtered in the kidneys and reduce the amount of urine that's produced.
2. An abnormally functioning placenta. There are four main reasons for a placenta with normal genetics to function abnormally: a.) A structural problem in the uterus such as a septum or some abnormality of shape and form. b.) "Immune" issues. The first thing the placenta does when it's forming is invade into the mother's tissues and establish vascular connections. While it remains controvertial exactly how to diagnose immune issues under the microscope it appears clear to me that in some people there may be problems in how the mother's tissues accommodate the foreign placenta. c.) Problems in how the blood vessels are remodeled by the placenta and how that remodeling process is tolerated by the mother. d.) Congenital viral infection. It's not uncommon for me to see intramniotic bacterial infection or congenital viral infection in babies with cord problems.
3. Abnormal pulse pressure in the cord. This can be related to fetal heart dysfunction (abnormal rhythmn, or can happen if the baby's heart is malformed and more stressed by the normal demands made on it during fetal life.
4. Velamentous, or membraneous, cord insertion. A normal cord is inserted on the placental side of the chorionic plate. The chorionic plate is the outermost of the two shells in which the baby grows and develops. On the placental side the chorion sprouts the villai that are the structures through which oxygen, nutrients and waste are exchanged between the baby's bloodstream and the mother's bloodstream. The cord's two arteries and one vein enter the chorion at a right angle. The placental side of the chorion is almost like a trampoline surface. If you were going to bend or tug at the cord at the point of insertion (thereby lessening the 90 degree angle at which the cord enters the chorionic plate), the chorionic plate will move in such a way that the blood vessels will stay open.
However, if the umbilical cord is inserted on the membraneous, or maternal, side of the chorionic plate, that's when troubles can arise. The membraneous side of the chorion is a very flat, paperthin sheet of tissue that runs up against the rigid myometrial wall. It has no give and, because of that, the the blood vessels that run from the cord to the plate are subject to compression or traumatic injury. This risk would increase as the baby approached the third trimester and amniotic fluid volume level started its normal rate of decrease as the baby got larger. At the time of membrane rupture a velamentous cord can be destabilized because the pressure of the amniotic fluid is no longer keeping the angle of the membranes and the plate open. It's very common for the fetal heartbeat tracing to acutely change and an emergency c-section to be required.
In addition to being vulnerable at the insertion site where the blood vessels are making that right angle, the blood vessels are also vulnerable further down along the cord. Those blood vessels have to travel in the membranes to the main body of the placenta, the mass of placental villi that are perfused by the mother's blood stream, and are where the nutrients actually are being extracted. The baby's head, elbow or knee can push against those blood vessels and they will have no place to go. They will be compressed, can be injured, and make it hard for the baby's heart and placenta to maintain their normal function, and keep healthy structure.
I wouldn't consider a velamentous or membraneous cord to be a true cord accident because the cord is mechanically set up to be vulnerable by abnormal placental migration. I can't blame the cord, then, if the root cause of the cord's problem is that the placenta grew out from underneath it. I need to try to figure out if there are any reasons why the placenta grew in such a direction. Sometimes, uterine septum can create a problem for the placenta. Sometimes, implantation down too close to the cervix can be the root cause. These each need to be evaluated carefully by clinician and pathologist to understand if there is any treatable underlying problem that caused the placental migration.
Carolyn Salafia, M.D., Ph.D., is board certified in Anatomic and Clinical Pathology and in Pediatric Pathology. She is a world-reknown expert on pregnancy loss and is one of a small handful of pathologists in this country who specialize in reproductive pathology. For more information, see her website,www.earlypath.com. Note: This communication is for educational purposes only and should not be used as a substitute for a consultation with your physician.
Was my doctor right in diagnosing a cord accident? by Carolyn Salafia, MD, Ph.D.
A "cord accident" is a very non-specific diagnosis that just means "something" happened to the cord. That "something" could be anything from a cord being wrapped around the baby's neck, to a cord prolapse, to umbilical blood vessel rupture. Cord problems are real problems, especially at term but commonly pathologists believe that a normal cord has enough built-in protection to save itself UNLESS there is some other kind of problem making it harder for the cord to function properly. That's why we look closely at the placenta to determine what might have caused the cord to fail. Although true cord accidents do occur in the third trimester, I have no recollection of ever coming to the conclusion of a pure cord accident in the second trimester when the amniotic fluid volume was normal, and the placenta and cord were healthy. Even in the third trimester I commonly find that a cord accident was a final event and not the cause of the problem that led to the baby's death. I generally conclude that the cord was put at risk because of another circumstance. In future pregnancies many of those circumstances wouldn't necessarily recur as a cord accident. Those maternal problems could manifest themselves in any one of a number of ways such as growth restriction, fetal death, preeclampsia, or preterm birth. That's why it's important for a pathologist to examine your placenta to determine exactly what caused your cord to fail.
To understand why a true cord accident--whereby the cord gets trapped or fails without some other process causing it to fail--is rare it helps to understand how the umbilical cord functions. The cord has two arteries wrapped around a vein. That means it has two outflow tracts and one inflow tract, centimeters at a remove from the baby's itsy-bitsy heart. The force of that little baby's hearbeat has to get blood all the way down the cord through a capillary bed where flow is necessarily very slow and then all the way back up the vein. The idea people have is that the only way Mother Nature allowed us to evolve such a stupid lifeline is because the cord is built to be able rescue itself most of the time.
To help protect itself, the cord has a substance called Wharton's Jelly around the blood vessels. It takes some force to actually move Wharton's Jelly but after the force is applied, the jelly will move and assume a new position. That means that if the cord is compressed it will remain where it is until the pressure becomes great. Then the Wharton's Jelly will cause it to move into a safer position.
In addition, the umbilical cord is covered by a skin that allows the cord to slip and slide at term even when there's not a whole lot of amniotic fluid, just like your intestines slip and slide in your belly. In fact, the cord is so slippery that when they're trying to encourage the placenta to be born, obstetricians may have to wrap the cord around their hands several times in order to get a good grip on it. If you have adequate fluid volume and a healthy cord I find it hard to understand how a cord could get wrapped several times around a baby's neck and stick there during the second trimester. I find it a lot easier to imagine how a floppy lifeless cord could drape itself around the neck of a child who has died and may be rotating in utero due to maternal positioning and gravity. Then, as the baby is delivered the cord would be pulled and tightened in its position as the baby descends and the placenta is retained attached to the uterine wall. But if there's enough amniotic fluid in the second trimester I can't see how the cord can get trapped. If a cord does get trapped in the second trimester with even a respectable amount of amniotic fluid then I have to worry about abnormal things in the amniotic fluid space that would cause epithelial erosion, like blood.
Since the cord is built to rescue itself under most circumstances, when a "cord accident" is diagnosed by an obstetrician, a reproductive pathologist will look for problems that might have increased the cord's vulnerability. Some of the questions I ask as I examine the placenta are: Was the placenta damaged so that the baby's heart would have had to work harder to pump blood through the placenta? Is there abnormal inflammation? Are there infarcts? Is the cord inserted on the wrong place, i.e. on the membranes instead of on the chorionic plate? Are the blood vessels abnormally straight? (In a normal cord the two arteries wrap around the vein and the pulsations of the artery help milk blood back up the vein. Some ultrasound studies have suggested that when there is not a helical coiling of the blood vessels, the straightness of the vessels is associated with a greater risk of problems. Presumably the idea is that if the arteries aren't lending their support to the vein, there might be an abnormality in how well the cord is functioning and it may be closer to a threshold where it doesn't rescue itself.)
At times (it's quite uncommon, and far less often than my clinician friends think it might be a cord accident!) I do diagnose a true cord accident in the third trimester. These would be:
1. A knot in the cord.
2. Spontaneous cord vessel rupture.
3. Nuccal cord. This is the medical term for a cord being wrapped around the baby's neck.
4. Cord prolapse. This is when the cord precedes the baby out of the uterus.
Also sometimes there is a problem with water flow and the umbilical cord Wharton's Jelly possibly isn't well hydrated. Or there may be something "bad" in the amniotic fluid space--like meconium or blood--so that the umbilical cord epithelium is eroded. Or there may be something abnormal in the organization of the arteries so that maybe the arteries don't help milk blood back along the vein the way they ought to. Then I would diagnose a cord accident.
However more commonly I find other issues that probably caused the cord to fail. There are more common reasons for the cord to get caught and have an accident; the frequency of each really varies with different hospitals and different groups of people. The most frequent causes of cord failure are:
1. Abnormal amniotic fluid volume. In the second and third trimesters amniotic fluid is mainly made up of the baby's urine. Normal kidneys can change their level of urine production depending on how much blood flow comes to them. Blood flow will be shunted away from the kidneys to more vital organs like the heart and the brain if there is a problem with oxygen delivery. If amniotic fluid volume drops off steeply I have to start wondering if there's some reason why fetal urine production is being reduced. If the placenta is insufficient or if the baby perceives low oxygen levels in its tissues, it will start shunting blood away from its kidneys to spare its vital organs. That shunting away will decrease the amount of blood that's filtered in the kidneys and reduce the amount of urine that's produced.
2. An abnormally functioning placenta. There are four main reasons for a placenta with normal genetics to function abnormally: a.) A structural problem in the uterus such as a septum or some abnormality of shape and form. b.) "Immune" issues. The first thing the placenta does when it's forming is invade into the mother's tissues and establish vascular connections. While it remains controvertial exactly how to diagnose immune issues under the microscope it appears clear to me that in some people there may be problems in how the mother's tissues accommodate the foreign placenta. c.) Problems in how the blood vessels are remodeled by the placenta and how that remodeling process is tolerated by the mother. d.) Congenital viral infection. It's not uncommon for me to see intramniotic bacterial infection or congenital viral infection in babies with cord problems.
3. Abnormal pulse pressure in the cord. This can be related to fetal heart dysfunction (abnormal rhythmn, or can happen if the baby's heart is malformed and more stressed by the normal demands made on it during fetal life.
4. Velamentous, or membraneous, cord insertion. A normal cord is inserted on the placental side of the chorionic plate. The chorionic plate is the outermost of the two shells in which the baby grows and develops. On the placental side the chorion sprouts the villai that are the structures through which oxygen, nutrients and waste are exchanged between the baby's bloodstream and the mother's bloodstream. The cord's two arteries and one vein enter the chorion at a right angle. The placental side of the chorion is almost like a trampoline surface. If you were going to bend or tug at the cord at the point of insertion (thereby lessening the 90 degree angle at which the cord enters the chorionic plate), the chorionic plate will move in such a way that the blood vessels will stay open.
However, if the umbilical cord is inserted on the membraneous, or maternal, side of the chorionic plate, that's when troubles can arise. The membraneous side of the chorion is a very flat, paperthin sheet of tissue that runs up against the rigid myometrial wall. It has no give and, because of that, the the blood vessels that run from the cord to the plate are subject to compression or traumatic injury. This risk would increase as the baby approached the third trimester and amniotic fluid volume level started its normal rate of decrease as the baby got larger. At the time of membrane rupture a velamentous cord can be destabilized because the pressure of the amniotic fluid is no longer keeping the angle of the membranes and the plate open. It's very common for the fetal heartbeat tracing to acutely change and an emergency c-section to be required.
In addition to being vulnerable at the insertion site where the blood vessels are making that right angle, the blood vessels are also vulnerable further down along the cord. Those blood vessels have to travel in the membranes to the main body of the placenta, the mass of placental villi that are perfused by the mother's blood stream, and are where the nutrients actually are being extracted. The baby's head, elbow or knee can push against those blood vessels and they will have no place to go. They will be compressed, can be injured, and make it hard for the baby's heart and placenta to maintain their normal function, and keep healthy structure.
I wouldn't consider a velamentous or membraneous cord to be a true cord accident because the cord is mechanically set up to be vulnerable by abnormal placental migration. I can't blame the cord, then, if the root cause of the cord's problem is that the placenta grew out from underneath it. I need to try to figure out if there are any reasons why the placenta grew in such a direction. Sometimes, uterine septum can create a problem for the placenta. Sometimes, implantation down too close to the cervix can be the root cause. These each need to be evaluated carefully by clinician and pathologist to understand if there is any treatable underlying problem that caused the placental migration.
Carolyn Salafia, M.D., Ph.D., is board certified in Anatomic and Clinical Pathology and in Pediatric Pathology. She is a world-reknown expert on pregnancy loss and is one of a small handful of pathologists in this country who specialize in reproductive pathology. For more information, see her website,www.earlypath.com. Note: This communication is for educational purposes only and should not be used as a substitute for a consultation with your physician.
Saturday, September 17, 2011
This happy day sucked...
17 years ago on September 15th, I met my husband for this first time. We celebrated 11 years of marriage, today. Well, I guess technically yesterday... since it's after midnight. With me being out of work after Nathan's death, we've gotten behind financially on some things. We had issues with our bank today, which had me in tears.
I had my 8-week post delivery OB appointment today also. I survived being the ONLY non-pregnant woman in the waiting room. Well, I take that back there was another lady there with her husband, son and newborn. It took everything in me to keep my composure. I lost it when I got in the room. I tried so hard to pull myself together before the doctor came in. I half managed. He talked to me for a few minutes but I could tell that he was at a loss for words. It was probably pretty awkward to have a half-naked women sitting on the exam table crying. You can't really come in and start off with "So, let's get this pap smear on the road!" He did encourage me to tell my story. He said it was important for me not to feel ashamed or embarrased by my loss.
Its days like this that make me wonder if I'll ever get through this. I think of Nathan every day but he doesn't consume my thoughts, like that first month. I can think of him, and even talk about him, without crying sometimes. Today felt so much like that first week. I just want this to NOT be MY life! I want to still be pregnant. I want to be 25 weeks pregnant. I want to be decorating the nursery and buying my little boy outfits and toys. Instead, Allen and I sat in the nursery today in an empty glider. A glider that I will never rock my baby to sleep in. I remember sitting in it the week before we lost him. I had checked on Cameron, before going to bed and had stopped outside the nursery door. I sat in the glider and looked around the room smiling, thinking of how different it was going to be checking on two kids. That image is now shattered beyond repair. I told Allen I think I want to sell it. He said we should keep it because "we never know". I have mixed feelings about it. I guess I'll keep it for now. Even if we have another baby, I don't know how I'll feel rocking him/her in that glider. I think part of me will always see it as Nathan's glider.
Today just kinda sucked. Never could I have imagined, 11 years ago, that this is where we would be. Marriage and life definitely haven't played out like I thought they would. Sometimes, I wish I had married a romantic man. Sometimes, I wish I had married a more sensitive man. But then, on days like today... during the rare moment when he just holds me and lets me be me; I can't imagine being married to anyone else. He's not perfect by any means, but he's enough for me. He loves me and accepts me with all of my imperfections. He may not be right by my side during each storm I face but I know that he will be there to pick me up and love me, when my world falls apart; and that's good enough for me.
I had my 8-week post delivery OB appointment today also. I survived being the ONLY non-pregnant woman in the waiting room. Well, I take that back there was another lady there with her husband, son and newborn. It took everything in me to keep my composure. I lost it when I got in the room. I tried so hard to pull myself together before the doctor came in. I half managed. He talked to me for a few minutes but I could tell that he was at a loss for words. It was probably pretty awkward to have a half-naked women sitting on the exam table crying. You can't really come in and start off with "So, let's get this pap smear on the road!" He did encourage me to tell my story. He said it was important for me not to feel ashamed or embarrased by my loss.
Its days like this that make me wonder if I'll ever get through this. I think of Nathan every day but he doesn't consume my thoughts, like that first month. I can think of him, and even talk about him, without crying sometimes. Today felt so much like that first week. I just want this to NOT be MY life! I want to still be pregnant. I want to be 25 weeks pregnant. I want to be decorating the nursery and buying my little boy outfits and toys. Instead, Allen and I sat in the nursery today in an empty glider. A glider that I will never rock my baby to sleep in. I remember sitting in it the week before we lost him. I had checked on Cameron, before going to bed and had stopped outside the nursery door. I sat in the glider and looked around the room smiling, thinking of how different it was going to be checking on two kids. That image is now shattered beyond repair. I told Allen I think I want to sell it. He said we should keep it because "we never know". I have mixed feelings about it. I guess I'll keep it for now. Even if we have another baby, I don't know how I'll feel rocking him/her in that glider. I think part of me will always see it as Nathan's glider.
Today just kinda sucked. Never could I have imagined, 11 years ago, that this is where we would be. Marriage and life definitely haven't played out like I thought they would. Sometimes, I wish I had married a romantic man. Sometimes, I wish I had married a more sensitive man. But then, on days like today... during the rare moment when he just holds me and lets me be me; I can't imagine being married to anyone else. He's not perfect by any means, but he's enough for me. He loves me and accepts me with all of my imperfections. He may not be right by my side during each storm I face but I know that he will be there to pick me up and love me, when my world falls apart; and that's good enough for me.
Monday, September 12, 2011
Drained
This was my Facebook post tonight...
"Ever have days when your mind is just blank... just so emotionally drained? I went to blog tonight and I can't even get the words/feelings out. I literally sat, staring at the keyboard. It's almost like... why bother. Nothing I feel, type or say is going to change anything. :-("
I figured maybe I'd come back on here... type that and something would trigger my brain. It really hasn't but I'm going to just type and see where it takes me.
Cameron started preschool on Wednesday. I'm so proud of him. When I picked him up, the teacher said, "He is so smart!" I love him so much... he is my greatest accomplishment. I feel bad sometimes because I feel like I love him more than Nathan. I feel like I'm being disloyal to Nathan or favoring Cameron. Then again, I guess it's not really that I love him more... just a different love. I never got a chance to bond and make memories with Nathan. I just have this fierce love for him. It's more of a protection I feel for him... like I have to protect his memory and make sure his life wasn't meaningless. I don't want to be the only person who knows he existed. I'm still trying to figure out why that's so important to me. As much as it hurts, it also makes me smile and my heart sing... to hear someone mention him or ask about his project.
I did good seeing Cameron's friend's mom... who's due date is the same week as mine was. She was coming down the hall as I dropped Cameron off on Wednesday. She wasn't looking up, so I don't think she saw me. I don't know if she knows what happened or not, but I'm sure she'll put two and two together when she sees my non-pregnant belly. I felt a quick, jolt when I saw her... like a stab in my heart. Of course, I didn't want to but it was like I couldn't stop myself. My eyes immediately traveled to her belly. Boom! There it was... a beautiful, perfect round belly. I've learned through a friend's Facebook page that she's having a girl. That sorta makes me feel a little better, although, I'm not sure why. I guess just knowing she isn't having a boy... as weird as that sounds. I teared up a little as I walked across the parking lot. I couldn't help but try to imagine if I was still pregnant, how that scene would've gone. We'd stop, smile and compliment each other on our big bellies, exchange a "how are you feeling", ect.
I was pushing Cameron on the swing, in the yard, earlier this week. When I looked up, I saw a little, orange butterfly on the grass, just sitting there. I think of Nathan every time I see one. It reminds me of how beautiful but fragile he was. A few minutes later, I started to walk Cameron over to my in-laws, across the street. As we walked by my car, I noticed the same butterfly flying past us. It stopped a little ways up the driveway and settled on the neighbors fence. As we walked past it, it fluttered down and landed beside our mailbox. I started smiling, thinking of Nathan's spirit in the butterfly, playing a sweet game of tag. It was almost like he was saying, "Catch me, mom!" As we got to the mailbox, it flew up and went around us and then flew away across the yard. Part of me wanted to catch it and hold onto it. However, just like with Nathan... I know it's a free spirit that isn't meant to be captured, just remembered.
"Ever have days when your mind is just blank... just so emotionally drained? I went to blog tonight and I can't even get the words/feelings out. I literally sat, staring at the keyboard. It's almost like... why bother. Nothing I feel, type or say is going to change anything. :-("
I figured maybe I'd come back on here... type that and something would trigger my brain. It really hasn't but I'm going to just type and see where it takes me.
Cameron started preschool on Wednesday. I'm so proud of him. When I picked him up, the teacher said, "He is so smart!" I love him so much... he is my greatest accomplishment. I feel bad sometimes because I feel like I love him more than Nathan. I feel like I'm being disloyal to Nathan or favoring Cameron. Then again, I guess it's not really that I love him more... just a different love. I never got a chance to bond and make memories with Nathan. I just have this fierce love for him. It's more of a protection I feel for him... like I have to protect his memory and make sure his life wasn't meaningless. I don't want to be the only person who knows he existed. I'm still trying to figure out why that's so important to me. As much as it hurts, it also makes me smile and my heart sing... to hear someone mention him or ask about his project.
I did good seeing Cameron's friend's mom... who's due date is the same week as mine was. She was coming down the hall as I dropped Cameron off on Wednesday. She wasn't looking up, so I don't think she saw me. I don't know if she knows what happened or not, but I'm sure she'll put two and two together when she sees my non-pregnant belly. I felt a quick, jolt when I saw her... like a stab in my heart. Of course, I didn't want to but it was like I couldn't stop myself. My eyes immediately traveled to her belly. Boom! There it was... a beautiful, perfect round belly. I've learned through a friend's Facebook page that she's having a girl. That sorta makes me feel a little better, although, I'm not sure why. I guess just knowing she isn't having a boy... as weird as that sounds. I teared up a little as I walked across the parking lot. I couldn't help but try to imagine if I was still pregnant, how that scene would've gone. We'd stop, smile and compliment each other on our big bellies, exchange a "how are you feeling", ect.
I was pushing Cameron on the swing, in the yard, earlier this week. When I looked up, I saw a little, orange butterfly on the grass, just sitting there. I think of Nathan every time I see one. It reminds me of how beautiful but fragile he was. A few minutes later, I started to walk Cameron over to my in-laws, across the street. As we walked by my car, I noticed the same butterfly flying past us. It stopped a little ways up the driveway and settled on the neighbors fence. As we walked past it, it fluttered down and landed beside our mailbox. I started smiling, thinking of Nathan's spirit in the butterfly, playing a sweet game of tag. It was almost like he was saying, "Catch me, mom!" As we got to the mailbox, it flew up and went around us and then flew away across the yard. Part of me wanted to catch it and hold onto it. However, just like with Nathan... I know it's a free spirit that isn't meant to be captured, just remembered.
Monday, September 5, 2011
A Good Weekend
It has been a good weekend... for which I'm thankful. It didn't start out so great on Friday and I was wondering if it was going to be all bad. I went to work and just before time to come home, a co-worker and I were approached by two other co-workers. They mentioned that they were going to do a cake raffle to raise money for another co-worker, who is out because of a car accident. I know I'm being emotional and over-sensitive but it kinda hurt my feelings. Two departments, that I don't even work with, gave me a card and money... one department before I even returned to work. I got a card from my department towards the end of the week when I returned, after I posted a thank you card for the other departments. It was appreciated but it almost felt like a "whoops, I guess we need to give" card. I was out almost a month. It felt like they all just forgot about me during that time and once I was back to work, they realized they hadn't done anything. I don't want people's pity but it would've been nice to have my loss acknowledged when it happened, not more than a month later. Another co-worker lost everything in a fire right before I had Nathan. They had money and furniture donations going to her the day after it happened. I know, I know... I'm being ungrateful. It just kinda bothered me. I should be happy that I received a card at all. What's the saying... "better late than never"?
Anyway, I got home and told Allen about it... which of course ended up with me crying. He and I talked for a bit. My therapist had been urging me to talk to him. Things haven't really changed for us but I feel a little better that he knows how I feel and I know where he is (as far as him acting the way he does about it). He's not trying to be mean or insensitive... it's just how he is. He was very close to his brother and he rarely talks about him. He basically feels like it won't change anything and that there's no point in living in the past. You remember them but don't dwell on the what if's or might have been's. If only I could get my mind wrapped around that idea... but I just can't. I asked him if he though what I was doing with Nathan's project was a good thing. He said, "Helping people is always a good thing." It felt good to feel like I had his approval and blessing. I'm not saying I needed it but it felt good to have my decision supported by him.
My sister-in-law and her husband went to PA to visit family for the weekend. They came home today and she brought a beautiful prayer shawl back. Their cousin, Hope made it for me. Isn't it beautiful?!?!
Most of this weekend has been spent being lazy. I didn't even get out of my pj's until almost 1pm today. I've got one load of laundry done. Well, almost done... they are dry in the dryer. ;-) I guess tomorrow will be spent trying to get things back in order for the work week to begin again.
Anyway, I got home and told Allen about it... which of course ended up with me crying. He and I talked for a bit. My therapist had been urging me to talk to him. Things haven't really changed for us but I feel a little better that he knows how I feel and I know where he is (as far as him acting the way he does about it). He's not trying to be mean or insensitive... it's just how he is. He was very close to his brother and he rarely talks about him. He basically feels like it won't change anything and that there's no point in living in the past. You remember them but don't dwell on the what if's or might have been's. If only I could get my mind wrapped around that idea... but I just can't. I asked him if he though what I was doing with Nathan's project was a good thing. He said, "Helping people is always a good thing." It felt good to feel like I had his approval and blessing. I'm not saying I needed it but it felt good to have my decision supported by him.
My sister-in-law and her husband went to PA to visit family for the weekend. They came home today and she brought a beautiful prayer shawl back. Their cousin, Hope made it for me. Isn't it beautiful?!?!
Most of this weekend has been spent being lazy. I didn't even get out of my pj's until almost 1pm today. I've got one load of laundry done. Well, almost done... they are dry in the dryer. ;-) I guess tomorrow will be spent trying to get things back in order for the work week to begin again.
Friday, September 2, 2011
Doctor Bill & Ultrasound
I've been debating for a couple weeks now, whether or not, to call my OB and ask for a copy of the pictures they took at my last appointment. The one where they told me Nathan was gone. I remember it seemed like she was taking a lot of pictures but I guess she wasn't taking many... just measurements. I finally called and I went today to pick them up. Well, 'them' turned out to be one. One picture. One picture of my son is all I got. I'm kinda wishing now that I had just left well enough alone.
I get home from the doctor's office and what does my lovely mailbox hold? The OB's bill charging me $1,900 for a vaginal delivery. They're kidding, right? I call the office to dispute the charges because I never saw the doctor. The 3rd shift nurse named Heather delivered my baby. I saw the doctor for a total of about 5 minutes the entire time I was in the hospital. It was long enough for him to basically tell me to "hang in there". I refuse to pay him $1,900 for his time. She said the doctor's submit their own charges. She supposed to look into it and call me back.
***UPDATE: Apparently, it was a "billing error". She said they've reimbursed the insurance company and they'll send me a new statement.***
Today sucks. I have to leave for work in about 30 minutes and I just want to hide under the covers. Allen seems to be in a crappy mood and it doesn't make me feel any better. My therapist recommended that I talk to him about how I've been feeling. I was thinking about it but now, I don't even see the point. I feel like nobody cares... like they're all just saying/acting like I should just get over this and pretend it never happened. I don't want to forget Nathan... but part of me wishes it were that easy. Forgetting and living without this pain and hole in my heart would be so much easier.
I get home from the doctor's office and what does my lovely mailbox hold? The OB's bill charging me $1,900 for a vaginal delivery. They're kidding, right? I call the office to dispute the charges because I never saw the doctor. The 3rd shift nurse named Heather delivered my baby. I saw the doctor for a total of about 5 minutes the entire time I was in the hospital. It was long enough for him to basically tell me to "hang in there". I refuse to pay him $1,900 for his time. She said the doctor's submit their own charges. She supposed to look into it and call me back.
***UPDATE: Apparently, it was a "billing error". She said they've reimbursed the insurance company and they'll send me a new statement.***
Today sucks. I have to leave for work in about 30 minutes and I just want to hide under the covers. Allen seems to be in a crappy mood and it doesn't make me feel any better. My therapist recommended that I talk to him about how I've been feeling. I was thinking about it but now, I don't even see the point. I feel like nobody cares... like they're all just saying/acting like I should just get over this and pretend it never happened. I don't want to forget Nathan... but part of me wishes it were that easy. Forgetting and living without this pain and hole in my heart would be so much easier.
Emotional
Wow, what an emotional week. I don't even know where to begin...
The third option I mentioned in my going back to work post happened tonight. A lady on 3rd shift looked at my stomach today and said, "So, when did you say you were due?" I wasn't prepared... I had to compose myself for a minute. I managed to mutter, "You didn't hear? I lost my baby. He was born July 21st." She quickly apologized and then seemed to really want to get away from me. We were in the gowning room and she started gowning up a lot faster. Maybe she realized how late she was or maybe it was just my imagination... but she seemed to be in a bigger hurry to leave the gowning room after that. Some days, I feel like I'm wearing a scarlet letter on my chest. I see people look at me, out of the corner of my eye. They have that sad "I feel sorry for her look." I don't want their sympathy or their pity. It would be nice to have their friendship. My loss isn't contagious. I don't have to be avoided like the plague. People that used to say hey and talk to me, don't anymore. It makes me mad but mostly, it just hurts. Some days, I feel like Nathan just consumes who I am. Its like walking through a cloud of cigarette smoke and I can't quite get the smell out of my shirt. Part of me feels like I'm obsessing about him. Everything I talk about or post on Facebook about, is about him or is another dead baby related post. How am I supposed to go back to who I was before? How am I supposed to incorporate him into my life without feeling obsessive or defensive? I've turned into this whole other person and I don't know who she is? I wonder if this is a fraction of what it feels like to have multiple personalities or be a mental patient? (Half joking, half serious)
I got on Facebook earlier today and people keep posting these comments like "I'm 14 weeks and I'm craving peanut butter" or whatever. I only noticed it on 2 people's wall. The first girl is pregnant so I figured it was just a random comment. The second person I don't know really, really well... so I was like "Oh, wow... she's pregnant." It kinda hit me in the gut... that pang of jealousy and sadness. A reminder that I'm no longer pregnant.
I get online tonight, after work... and its on more and more walls. I just kept reading it over and over. I finally read, on the Teen Parents of Angels' wall, what it was all about. Apparently, it's a game supporting breast cancer. What??? Here's how it works...
Let's go with my birthday. Can someone explain to me how in the hell posting "I'm 4 weeks and I'm craving Kit-Kat" on my wall is supposed to show my support of breast cancer? Anyone? Someone?
The third option I mentioned in my going back to work post happened tonight. A lady on 3rd shift looked at my stomach today and said, "So, when did you say you were due?" I wasn't prepared... I had to compose myself for a minute. I managed to mutter, "You didn't hear? I lost my baby. He was born July 21st." She quickly apologized and then seemed to really want to get away from me. We were in the gowning room and she started gowning up a lot faster. Maybe she realized how late she was or maybe it was just my imagination... but she seemed to be in a bigger hurry to leave the gowning room after that. Some days, I feel like I'm wearing a scarlet letter on my chest. I see people look at me, out of the corner of my eye. They have that sad "I feel sorry for her look." I don't want their sympathy or their pity. It would be nice to have their friendship. My loss isn't contagious. I don't have to be avoided like the plague. People that used to say hey and talk to me, don't anymore. It makes me mad but mostly, it just hurts. Some days, I feel like Nathan just consumes who I am. Its like walking through a cloud of cigarette smoke and I can't quite get the smell out of my shirt. Part of me feels like I'm obsessing about him. Everything I talk about or post on Facebook about, is about him or is another dead baby related post. How am I supposed to go back to who I was before? How am I supposed to incorporate him into my life without feeling obsessive or defensive? I've turned into this whole other person and I don't know who she is? I wonder if this is a fraction of what it feels like to have multiple personalities or be a mental patient? (Half joking, half serious)
I got on Facebook earlier today and people keep posting these comments like "I'm 14 weeks and I'm craving peanut butter" or whatever. I only noticed it on 2 people's wall. The first girl is pregnant so I figured it was just a random comment. The second person I don't know really, really well... so I was like "Oh, wow... she's pregnant." It kinda hit me in the gut... that pang of jealousy and sadness. A reminder that I'm no longer pregnant.
I get online tonight, after work... and its on more and more walls. I just kept reading it over and over. I finally read, on the Teen Parents of Angels' wall, what it was all about. Apparently, it's a game supporting breast cancer. What??? Here's how it works...
Ok pretty ladies, it's that time of year again, in support of breast cancer awareness!! Remember last year so many people took part that it made national news and, the constant updating of status reminded everyone why we're doing this and helped raise awareness!! Do NOT tell any males what the status' mean, keep them guessing!! And please copy and paste (in a message )this to all your female friends to see if we can make a bigger fuss this year than last year!!! I did my part... now YOUR turn!
The idea is to choose the month you were born and the day you were born. Pass this on to the girls only and lets see how far it reaches around. The last one about the bra went round allovr the world. So you'll write... I'm (your birth month) weeks and I'm craving (your birth date)!!! as your status.
Example: Feb 14th = I'm 2 weeks and craving Choclolate mints!!
January - 1 week
Febuary - 2 weeks
March - 3 weeks
April - 4 weeks
May - 6 weeks
June - 8 weeks
July - 10 weeks
August - 12 weeks
September - 13 weeks
October - 14 weeks
November - 16 weeks
December - 18 weeks
Days of the month: 1-Skittles 2-Starburst 3-Kit-Kat 4-M&M's 5-Galaxy 6-Crunchie 7-Dairy Milk 8-Lollipop 9-Peanut Butter Cups 10-Meat Balls 11-Twizzlers 12-Bubble Gum 13-Hershey's Kisses 14-Chocolate Mints 15-Twix 16-Resse's Fastbreak 17-Fudge 18-Cherry Jello 19-Milkyway 20-Pickels 21-Creme Eggs 22-Skittles 23-Gummy Bears 24-Gummy Worms 25-Strawberry Pop Tarts 26-Starburst 27-Mini Eggs 28-Kit-Kat Chunkie 29-Double Chocolate Chip Chrunchy Cookies 30-Smarties 31-Chocolate Cake
Let's go with my birthday. Can someone explain to me how in the hell posting "I'm 4 weeks and I'm craving Kit-Kat" on my wall is supposed to show my support of breast cancer? Anyone? Someone?
The girl that "runs" the TMOA's page apparently got into a spat with some of her friends, by telling them that it was hurtful to baby loss parents. She was basically thrown under the bus (so to speak)... even by a couple women who said they'd had miscarriages. Here was my response to her...
Don't let them get to you. They clearly don't understand and I thank God that they don't. I'm less than 6 weeks into my loss. It was like a punch in the stomach every time I read one of these postings today. I know its meant to be a game but for me, personally, it's a reminder that I'm no longer pregnant. We're not saying "poor pitiful me"... we're saying support breast cancer in a way that actually supports breast cancer. I didn't even know what the posts were about until I read this posting. How am I supposed to help support breast cancer with a game that I don't even know that's want its purpose is? A game that slaps me in the face and reminds of my new reality... a mom that is no longer pregnant. A mom that had to hold her lifeless child in her arms. I'm glad that those women who suffered losses are able to play and not find it offensive. Perhaps one day, I'll get to a place of peace and resolution like they have. Right now, I'm just not. My grief and emotions are too fresh and raw. Perhaps we're taking this too personal... but for us, this hurts. We don't need to apologize for being hurt by this. It is what it is. Part of me feels like posting... "I should be 23 weeks pregnant. Right now, I'm craving my son Nathan in my arms."
You know what... I'm almost ready to say "screw it" and not care who gets offended and actually post it on my Facebook page.
***Update about 10 minutes later: I just scared the hell out of myself and did something that is so unlike me. I'm literally sitting here shaking. Part of me is scared about the reaction I'll get from people... and part of me could care less. I just posted a picture, on Facebook, for an event helping support a friend who's fighting breast cancer. Here's what I just posted on Facebook above it...
Well, the blogging didn't help. It just ticked me off more. In advance, I apologize to anyone this offends. Here's my response to the breast cancer support game going around. "I should be 23 weeks. Right now, I'm craving my son Nathan in my arms." If you really want to support breast cancer... click on the picture below. Attend the event or send money to help Tanya Ray Gunter fight breast cancer!
I wonder how times I'll get "de-friended" over this one?
***UPDATE: Two days later, I ended up with a total of 10 de-friends. Oh, well...***
***Update about 10 minutes later: I just scared the hell out of myself and did something that is so unlike me. I'm literally sitting here shaking. Part of me is scared about the reaction I'll get from people... and part of me could care less. I just posted a picture, on Facebook, for an event helping support a friend who's fighting breast cancer. Here's what I just posted on Facebook above it...
Well, the blogging didn't help. It just ticked me off more. In advance, I apologize to anyone this offends. Here's my response to the breast cancer support game going around. "I should be 23 weeks. Right now, I'm craving my son Nathan in my arms." If you really want to support breast cancer... click on the picture below. Attend the event or send money to help Tanya Ray Gunter fight breast cancer!
I wonder how times I'll get "de-friended" over this one?
***UPDATE: Two days later, I ended up with a total of 10 de-friends. Oh, well...***
Thursday, September 1, 2011
Questions
I really like "Glow in the Woods". It's turning out to be a very healing site. Reading the posts on there, really get me thinking. I'm not a very good writer... especially when it comes to feelings. I've always been more of a "bottle-it-up-and-just-deal-with-it" kinda person. I hate to have just a copy/paste post... but this is the best way I know to start writing. I'm starting off with small bits and pieces, by reading and responding to other stories. Who knows, maybe one day I'll get to a point of being able to really "bear my soul". Right now, I just can't... not all at one time. This is as good as it gets for now.
Here's the post...
http://www.glowinthewoods.com/home/2011/6/30/the-smallest-jar.html?lastPage=true#comment14961032
Here's my reply...
I'm a little late to this posting but I'm new. I wanted to join in... especially after getting the following question asked today. (I lost my son, Nathan, at 4 months gestation. I was induced and delivered him on July 21, 2011. I've been back to work less than 2 weeks now.) My mom had a memorial shirt made, for me, with my son's name on it. A lady at work said, "Oh, I love your shirt! It's so pretty... what does it say? (pause while she reads the poem) Whose name is that?" I said, "It's my son's name." She looked at me, straight-faced, and said, "Oh, you named him?" In my mind, I was like 'Um, yeah... why wouldn't I?' My supervisor happened to walk up, so I didn't answer her... I just walked off. It bothered me. It hurt. It pissed me off. It made me sad to think that the only person who thinks my son's life mattered is me... or at least that's how I feel. I wonder if she would've asked me that if I'd carried him full-term and he died? I really hate the image people have of miscarriage... like it's just a procedure or something that happened.
Another question I hate... Are you going to try again? Ugh... I HATE this one! My son's been gone less than 2 months. Really, you feel the need to ask me that?!?!?! It took me 5 years and a fertility specialist to get pregnant with my first son and 3 years to get pregnant with Nathan. I've had a constant supply of negative pregnancy tests, over the years, to remind me of how infertile I am. Now, I get to be reminded that I have a dead child also. Apparently, one that people feel will be replaced by having another one. I failed at carrying him... so I guess they think I need to try again?!?! As I was told by another co-worker, "Maybe, the next one will work out." Yeah, its like trying on a dress. This one didn't fit... maybe the next one will."
I'm starting to think I'm surrounded by stupid people. :-(
Here's the post...
http://www.glowinthewoods.com/home/2011/6/30/the-smallest-jar.html?lastPage=true#comment14961032
Here's my reply...
I'm a little late to this posting but I'm new. I wanted to join in... especially after getting the following question asked today. (I lost my son, Nathan, at 4 months gestation. I was induced and delivered him on July 21, 2011. I've been back to work less than 2 weeks now.) My mom had a memorial shirt made, for me, with my son's name on it. A lady at work said, "Oh, I love your shirt! It's so pretty... what does it say? (pause while she reads the poem) Whose name is that?" I said, "It's my son's name." She looked at me, straight-faced, and said, "Oh, you named him?" In my mind, I was like 'Um, yeah... why wouldn't I?' My supervisor happened to walk up, so I didn't answer her... I just walked off. It bothered me. It hurt. It pissed me off. It made me sad to think that the only person who thinks my son's life mattered is me... or at least that's how I feel. I wonder if she would've asked me that if I'd carried him full-term and he died? I really hate the image people have of miscarriage... like it's just a procedure or something that happened.
Another question I hate... Are you going to try again? Ugh... I HATE this one! My son's been gone less than 2 months. Really, you feel the need to ask me that?!?!?! It took me 5 years and a fertility specialist to get pregnant with my first son and 3 years to get pregnant with Nathan. I've had a constant supply of negative pregnancy tests, over the years, to remind me of how infertile I am. Now, I get to be reminded that I have a dead child also. Apparently, one that people feel will be replaced by having another one. I failed at carrying him... so I guess they think I need to try again?!?! As I was told by another co-worker, "Maybe, the next one will work out." Yeah, its like trying on a dress. This one didn't fit... maybe the next one will."
I'm starting to think I'm surrounded by stupid people. :-(
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