Thursday, March 31, 2011

The Gifts of Grief

I think that perhaps there are two kinds of people in the world. Those who have gone through grief and those who haven’t. I know, I know, everyone has tough stuff that they go through. Bad break-ups, parent issues, friend issues, work stuff, you name it. But grief is different from other hard stuff. It overshadows everything around it, puts everything in perspective as the small and conquerable thing it is and shows you who the people around you really are.
I feel like I’ve crossed to the other side of this line in the last few weeks. None of the things I worried so much about before seem to matter as much now and the things that do matter seem so much bigger and better than they did before. My children matter, my husband matters. Whatever childhood issues I had with my parents don’t matter now, friends who don’t know what to say don’t matter so much now, stage-fright doesn’t matter now, appearances don’t matter now.
In a way this is liberating. There is a joy in not caring about the trivial and having enough perspective to appreciate that which is real. The real things are more precious than I ever thought possible. My children, my husband, my true friends have become more real and more necessary to my life than they were before. It is liberating to know this because it frees me from the distractions of other things. I’m less distracted by my own selfishness and laziness that prevent me from keeping a nice home. I’m less worried about how others will view my life and my choices and simply parent my children in the way that my instincts dictate. I find myself being the mother I’ve wanted to be, more patient, less quick to anger, more reasonable in my disciplining. Grief has given me that and I am grateful.
I find I have a glorious filter in place now. The good can come in, the unintended bad stays at arms length where I know that it isn’t meant that way and can ignore or dismiss it as necessary. I don’t know if this is a side effect of grief or if it’s just my optimistic personality asserting itself after six weeks of being dormant. I rather think it’s the grief and I’m grateful for it.
I’m grateful for the perspective and the liberation and the reforms to myself, I’m grateful for the filter and the joy that is all the more sweet for having been absent.
“Whatever my lot, thou has’t taught me to say, it is well, it is well with my soul.”

Tuesday, March 15, 2011

Riding the wave

My mom says that grief comes in waves. You feel better for a few days, then worse for a few more, then back to better again. The idea is that eventually the better days are more frequent and the bad days less until you can think of the departed without being devastated.
Today is a better day. I looked through the box with Joel's things in it. I touched the box that holds his ashes, I looked at his little footprints, I saw the little blood smear on the ribbon of his impossibly tiny hat. I was sad but I didn't fall apart. I added the picture that the Pudding drew of Baby Joel up in Heaven and lingered for a moment, then put the lid down and went on about my day.
Sunday night was a bad night. I went to the grocery store after the kids were in bed and on my way home I just felt so alone and sad and generally depressed that I really wanted to hit that old Self-Destruct button. For those not familiar with this one allow me to explain.
For women from a certain background, usually children of divorced parents, often with some form of abuse during childhood, good things feel unfamiliar. When women from this certain background get sad or depressed about something, they seek the familiar and for them, it's usually more crap. This concept explains most of my relationships in my early 20's. I saw the pattern repeated in more of my friends than I know how to count. We'd get an urge to do just the worst thing for ourselves that we could. Sometimes that was to eat too much, have sex with inappropriate people, drink too much, max out a credit card, quit a good job, ditch a nice boyfriend.
That last one is one I actually did to poor Dilbert when we were dating. He'd just driven me to Wisconsin and back for my step-father's funeral and I was a wreck most of the way back. I'd been trying to do the strong, supporting daughter/sister thing for my mom/step-sister while we were there and about 5 minutes after we got on the road to come home, I snapped, hit a dear, broke Dilberts headlight and cried my head off to my incredibly sweet and supportive boyfriend. Needless to say, he drove the rest of the way home to DC.
A few days after we got back I told Dilbert that I didn't deserve him. He didn't deserve a mess like me. He was a nice guy who deserved a nice girl who would treat him accordingly, not someone who freaked the fuck out every couple of months. I told him I had so many issues to work out right then that he couldn't help me with and he didn't need the hassle. He cried, I cried, we cried some more and then he went home.
I hung out with my crazy friends that week that we were apart. I drank too much, smoked a lot of clove cigarettes (my chest ached) and had cheese puffs and Mountain Dew for diner a few nights. I was on the phone with one of my guy friends and strangely enough we were talking about relationships. I told him about the way that Dilbert always listened to me so well, like he was really trying to understand me and how selfless he was in driving me across the country to go to a funeral of a man he'd never met. I talked about how he'd talked to my grandparents even though he really didn't care much about old cars or religion. My friend said, "If you've found someone like that, why are you on the phone with me?" I took the hint and called Dilbert at 12:01am, February 14th, 2005 and married him 9 months later.
The funny thing here is that I had to make the decision against my gut instinct to do the thing that was good for me. For most people the thing that is good for them is the thing they would rather do. Not so for me, the thing that feels familiar is not good, the thing that I gravitate to is usually bad for me and will leave me feeling just as helpless and scared as I spent many of my formative years.
Since I married my Dilbert, the self destruct urge has fallen off quite a bit. Yes, I still get the urge to spend too much money or eat the entire pan of brownies knowing that I'm going to regret both later but for the most part, I'm much more even keel.
This last week, not so much. Not only do I want to eat the whole pan of brownies, I want to do it while downing a 6 pack of hard cider and possibly smoking more cloves. I want to do things that would be bad for me because then maybe the hurt would be controllable. I know how to dig myself out from under my own mess, I've done it more times than I care to mention. I don't know how to dig myself out from under this and when I have one of those bad days mentioned above, it feels like nothing is going to feel right ever again. I feel the weight of the decision we had to make and the judgment of every right-to-lifer who has never met me and doesn't know my situation. I feel my own judgment and that of every friend who had a funny look cross her face when I told her what we were going to do. I feel the weight of the judgment of every mother who carried to term with the knowledge that her baby wouldn't live and just counted herself grateful for the experience. I don't know most of the people mentioned above but I feel the weight nevertheless. That weight makes the 3 lbs I'd gain from the brownies seem rather insignificant.
But, on days like today, all that judgment doesn't seem to matter. I know my baby is being cared for in Heaven, I know that he was able to feel a mother's touch if only for a moment and I know that I did all in my power to make his short life sweet for him while making things manageable for myself. I know that my conscience is clear on this particular point and I know that God understands the choice I made and loves me none the less. Secure in that knowledge, I will continue to ride the wave as best I can without aid of the self destruct button.

Saturday, March 12, 2011

Baby Joel

Our Sweet Baby Joel came into this world on March 8th, 2011. We induced his birth because of some very serious brain malformations that had occurred that were incompatible with life. We made the heart wrenching decision to terminate the pregnancy and here is the story.

Our son Joel has no frontal lobe in his brain. We were told at 12 weeks that he would not be able to survive outside the womb. We were sent home with a difficult decision to make. Terminate this very wanted pregnancy or continue it with the knowledge that a baby wasn't going to be living with us afterwords. We read, we did research, we got second opinions. Everything we read pointed us toward termination. We have two children already, they need a mother who can do more than cry in bed most of the day and a father who can go to work everyday and earn a living. We both need to be there for these kids and we felt crippled by this knowledge. The more research we did, the more it looked like this baby wouldn't make it to term anyway. He would most likely come late in the 2nd trimester. The doctors we talked to said that a stillbirth at that time can be risky for the mother and future pregnancies. Technical names like incompetent cervix or uterine scaring were thrown around while our heads were spinning.
The night we got our diagnosis I told my husband that I wished I could just give birth and have this over with. I wished that I could have the baby and hold them and tell them goodbye and then begin to heal and look toward the future without the awful waiting period of pregnancy to go through first. As we looked into our options, we realized that this was possible but were told that it probably couldn't happen for about 6 weeks. Then at our 14 week visit with the high risk OB/Gyn they told us that they had found a doctor who could and would do an induction of labor but only if we agreed to do it the next week. He felt that the risks would be higher if we waited. He also turned out to be the only doctor in our very large metropolitan area who would consider doing an induction at all so he was our guy. Our other options were to do a D&C (Dilation and curettage, they use tools to scrape out the contents of the uterus) or a D&E (Dilation and Evacuation, they use suction to empty the uterus). Neither of these options would allow us to see or hold our child, I would be unconscious for the procedure, neither of these options would give us the closure we were so desperately searching for and neither of these felt like a good way to honor the person-hood of our child.
After all the discussion, all the weighing of options was over, we decided to trust this doctor and do this on his time table. We made arrangements for our kids, my midwife Kim was able to come with us and we checked into the hospital late on a Monday night at 15 weeks 3 days gestation.
I was hooked up to an IV. I argued to have a hep-loc instead of a constant IV so that I could have more freedom of movement. They drew blood and then the doctor took out the laminaria that his partner had placed that morning.
The laminaria are little bits of seaweed that absorb water and when placed in the cervix, they will expand and dilate the cervix. The partner had put in the laminaria that morning and then placed two sponges behind them so that they wouldn't fall out before they expanded. When we got to the hospital the doctor took out the sponge but was having some trouble finding the other one. His examinations had been rough from the start but were quite painful when he was looking for the other sponge. It turns out that the sponges had been squished together and had both come out already. He finally realized this and removed the laminaria. Then he put in the first dose of Cytotec.
Cytotec is a medication that is used for people who have ulcers. It was not developed for women who are in need of an induction. The strong uterine contractions it causes are a side effect of the drug. The drug is commonly used against label because it works so well at bringing on labor but in full term pregnancies it does have some very nasty side effects like hyper-stimulation of the uterus and a marked danger of uterine rupture when used for a vaginal birth after Cesarean (VBAC). Because this wasn't a full term pregnancy, hyper-stimulation was of less concern to us and since I have never had a Cesarean, we felt cautiously safe about using it.
I went to sleep after the first dose and didn't wake up until 5am when the nurses assistant came in to check my vitals. I reminded them that I was supposed to have gotten another dose of Cytotec at 3 and the resident came in and gave me another dose. The drug was inserted as close to the cervix as the doctors could get it and about 15 minutes after the 2nd dose was given, labor really started to kick in.
Kim had gone home for the evening but by 6 am the contractions were strong enough that Dilbert felt that he needed to call her to come back. It turned out that that was a really good idea.
The contractions were not like any I'd ever felt before. They didn't rise in a wave with a peak and a rest in between. They came in jumps and starts. I'd have about 40 seconds of rest and then a 30 second contractions that hit me like a truck. Then it would be gone. Later, I had longer breaks but much longer contractions, it felt like there were 2 or 3 of them coming on top of eachother with no break in between.
I tried several different positions but just couldn't seem to find one that helped ease the pain at all. Kim had left the birth ball with us but the room was too cold and I didn't want to be out of bed for very long. Plus, by then they had insisted on an IV and nothing by mouth so moving around was difficult.
I got back into bed and just tried to sit forward as much as possible. We put the bed all the way up so that it would support me and I tried to sit cross legged but that was uncomfortable too. Toward the end I asked Dilbert to stand at the end of the bed and let me pull on his arms so that I would be leaning forward.
I'd asked him too before and so he kept reminding me that we were doing the right thing. When contractions got more intense I started to sob through them. The nurses, when they were there, talked about getting me something for the pain but in the middle of a massive contraction I shouted "No! No! No! I'm only going to have a minute with him, I don't want to be loopy!"
As the contractions kept coming and I kept crying I started whimpering for Kim. Whenever I had a rest I tried to remind Dilbert that it wasn't because he was doing a bad job, he was great, I just knew Kim was bringing the heating pad and her calming presence and I really felt like I wanted both right away. She did get there at about 7:30. She slipped in quietly while I was in the throws of a contraction, held my hand for another one and said I sounded "Pushy." "Maybe you should just try a little push with the next contraction." she said.
When the next one hit, I gave a little push and it felt so good to do something with this one. I pushed just a little and felt something come out. I threw back the blankets and there he was.
I started wailing then and told Dilbert to pick him up so he could feel a loving touch in case he was still alive. I looked at him an wailed and wailed and cried like I never have before. There was a Bible verse that kept going through my head. It was from the Matthew 2, the slaughter of the innocent by Herod, what went through my head was "WEEPING AND GREAT MOURNING, RACHEL, WEEPING FOR HER CHILDREN, AND SHE REFUSES TO BE COMFORTED, BECAUSE THEY WERE NO MORE."
Joel was not born with a heartbeat so we had them clamp and cut the cord so that I could hold him. I asked Kim to steady my hand because I was shaking and weeping so hard. I kept saying "I'm so sorry baby, I'm so sorry." over and over again.
The doctor came in and started trying to grab the placenta. He couldn't reach in (though he tried despite my protests and obvious discomfort). He ran out and Kim told me to push with everything I had so that I wouldn't have to have the really scary drugs that he was running to get. I pushed just a little and it came out intact. Kim did a fundal massage then to help the uterus clamp down but I really don't remember much of what happened after. I was looking at the baby.
He was absolutely perfect on the outside. He had these perfect little hands and feet. This tiny little chin and even ears. He had the sortof bug eyes of a 15 week fetus but he looked as perfect as he could. His skin was very thin and so this made him look very red. We had thought about letting the Pudding come see him but ruled that out because of this. After he had been out for a little while, I could feel him getting colder so I put him on my chest to keep him as warm as I could. I knew it wouldn't do any good for him, that he wasn't really in there anymore but some primal maternal instinct told me I had to keep my baby warm so that's what I did. We wrapped him in a blanket that had been made for him, it was too fuzzy and left little bits of wool on him but I really wanted to keep him warm so I didn't mind the fuzz.
We had him with us for about 3 hours. A friend who is part of the Now I lay me down to sleep group came and took some pictures for us. The photo at the beginning of this post is her work. A kind nurse took him to print his feet and weigh him. She did some clay impressions of his feet as well. She handled him so gently and kept him covered while she had him out. I was so grateful for that. I thought he was beautiful but I knew others wouldn't see him that way so I was glad she kept him away from the eyes of others.
The longer he was out the more we could see changes in him. He began to wrinkle and whither a little. His skin dried out and he sortof seemed to sink a little. Despite my best efforts, I couldn't keep him warm anymore so we knew it was time to say goodbye. We held him and kissed him and told him we loved him very much. I told him I would miss him. Then we handed him over to the nurse who took him away.
We had him cremated and have him at home now. We had a small funeral for him yesterday. In the days in between his death and his funeral we actually felt a lot better. We felt like the weight of decision had been lifted and we were out from under the burden of this huge aweful thing that had come to us for the first time in nearly a month. Today is a little harder, we have to get back to normal now, I have to start cooking again, Dilbert has to go back to work on Monday, we have to discipline our children and be parents again. I'm sure things will get better soon, we feel like we now have the permission to look to the future again. We're making plans to not make plans. We're going to take a trip, we're going to move on past the darkness.