One month since our angel went to heaven

Miss you, little girl. 

Peace of my heart

It has been almost one month.  On December 28, I had a nice lunch out with Adrian and I remember the baby kicking away while we sat in the restaurant.  "She likes Tilapia," I said. After lunch, Adrian dropped me off at my OB's office for my routine check.  Angeline's heart rate was checked (normal).  My exam was as expected.  I had a relaxing evening at home that night, I was lounging around, watching a movie.  The following morning I woke up and she was gone.  Just like that.

What a month...

It seems that the autopsy may yield some answers after all.  Although we do not have the full conclusive report yet, I have received a preliminary report.  It seems that Angeline's heart had some significant abnormalities, which probably resulted in her death.  Other findings suggested that she had been in stressful conditions for some time, I believe she was hanging on and fighting for as long as she possibly could.

This came as a surprise.  As I have mentioned before, none of my screening tests raised any suspicion of cardiac abnormalities.  I had routine ultrasounds which were apparently normal.  I actually had repeat ultrasound imaging of the outflow tracts of the heart at 22 weeks.  Not because anything was thought to be abnormal, but just because she was moving so much at the 20 week scan, there was some difficulty in actually getting the views they needed.  No one suspected a cardiac problem at any point.

In a sense, I believe learning of Angeline's heart defect will give us some peace.  First of all, I have decided that nothing is worse than knowing nothing.  In more than half the cases of stillbirth in the US, families never learn why their baby died.  Not knowing is such a terrible haunting experience.  The pain of thinking that your normal, healthy baby was lost for unknown reasons is excruciating. This past month I have suffered with the belief that our healthy girl was lost.  It appears that our case will be one where we are afforded the opportunity for a sense of closure as regards the cause of her death.  

This finding presents the possibility that Angeline's loss before birth was the lesser of two evils.  If she were to have been born with a severe heart defect, she may have been subjected to surgeries and invasive procedures as an infant, maybe to survive, but maybe not.  What would have been the quality of her life?  It would have been infinitely harder to watch my infant girl suffer and die after trying to fix her broken heart...

So strange...  Of all the things I was worried about with my pregnancy, this wasn't one of them.  I was very anxious about a first trimester loss.  I was a little worried about genetic problems such as Down's Syndrome.  As time went on, I worried about the possibility of preterm labor - of course, by the time I was almost 31 weeks I felt I was almost in the clear.  A few more weeks and she would probably do just fine, even if I went into labor early.  It never even occurred to me to worry about congenital heart disease.  I actually have a friend whose baby was born with Tetralogy of Fallot, and thanks be to God, did very well with his repair surgeries and is now thriving.  How unlikely it would be for my baby to have a congenital heart defect!

This just goes to demonstrate something my mother and I have said many times: it just doesn't make much sense to worry, because it is not the things that you worry about, but the things that you least expect that come up and really take you down.  I have experienced this and seen this time and time again.

To know that little Angeline's heart had not formed properly at a very early stage of development reinforces  the fact that every life is a complex and miraculous victory.  The development of a healthy baby is absolutely nothing short of a miracle.  In Angeline's case, I believe that she hung on as long as she could.  In doing so, she touched so very many lives here on earth.

I will close with I lovely sentiment from the website of Now I Lay Me Down To Sleep:

"There is no foot too small that it cannot leave an imprint on this world."

Letting go

Twice this week I was asked the same question by two different people, "Where are you with God on this?" 


Sometimes a tragedy can result in loss of faith, or doubt in one's beliefs.  Alternatively, one can turn to religion for comfort.  In my case, I think I have experienced a little of both, and also a third phenomenon: coming to the inevitable conclusion that we have little to no control over our path in life and making the choice to resign ourselves to that relative helplessness.  So called "letting go."  Whether you want to think of this as God's plan ("let go and let God"), succumbing to fate / destiny or random chance, the bottom line is, try as we might, we don't have much control over the course of our existence.  At times, it is hard to remember that it works both ways - that is to say, we neither have control over what we perceive as good, nor what we believe to be bad experiences in our lives.  While on some level, I am angry and upset that my child was taken away from me, I am also grateful that I have been blessed with the ability to conceive and carry a child at all, something that many couples struggle with.  I am fortunate that I found a partner that I want to raise a child with.  I am appreciative for the time I had to nurture my daughter, to bond with her.  My feelings remind me of a popular Christian song, "Blessed Be His Name," in which the lyrics say, "He gives and takes away..."  Even if you do not accept God as being in control of your life, the truth is you had no control over the circumstances you were born into, nor most of the things that led you to your current position in life.  Certainly, you did not choose the parents you were born to, the opportunities you were given as a child, etc.  Not to mention, so many chance encounters and occurrences along the way to reaching your current place.  Some of them good, some of them bad.  In my own case, I can think of many seemingly random, chance events without which I never would have carried Angeline at all.  This is not to say that we have no responsibility for where we are, or that our actions cannot alter our course in some ways.  My point is that there are many circumstances beyond our control that have significant bearing on our course. 

In answer to the question, "Where are you with God on this?"  I have answer that I don't know why God has given us the pain of this loss to bear.  I am not sure why we are now heading down this new path that is so much different than the one we expected.  I hope that somehow my little Angeline has been spared from pain and suffering, I hope that she is in a good, peaceful place now.  I hope that her loss, that has touched so many people, brings all of us new respect for the sanctity and the miracle of life, as well as appreciation for so many blessing that have been bestowed on us.  I hope that this difficult experience changes us in ways that are positive - to become more loving, more compassionate individuals.  Though we did not choose this experience, it is now a part of us. 

An interesting week...

The third week of January 2011...

First of all, I went back to work this week.  I stayed home for roughly two weeks after delivering Angeline.  The physical recovery from delivery was not too bad.  For two weeks I devoted myself to grieving for the loss of our daughter, reading books on the topic, educating myself on potential causes of this tragedy, reading the stories of other women, spending time with my immediate family and a few close friends.  I let myself be completely miserable sometimes, and to sleep as much as I needed to.  The fog started to clear.  I realized that I could literally think about this all day every day if I allowed myself to.  For me, it seemed right to try to start to get back to my usual routines.  So, I returned to work.  The first day, I felt pretty good.  The second day, I cried on the way home.  Ups and downs are to be expected, I think.  I am so fortunate to work with a wonderful group of people, who have been incredibly supportive and sympathetic.  Even those I have not been close with have simply approached me, saying, "I'm so sorry, we love you," and hugged me, which has meant so much to me.  It is just so hard to keep my head up and keep smiling, though. 

Mid-week I started to become slightly more anxious about the results of Angeline's autopsy.  Although her body was released to us the first week of January, the pathologist has not given any report to my obstetrician as of yet.  We had hoped to have a full report early this week.  We have heard absolutely nothing, and the pathologist has been quite difficult to contact, from what I understand.  On Thursday, the staff at my OB's office was finally able get though to the pathologist's office and speak to one of his staff.  It seems that the results are in progress, but may take up to sixty days for a full report.  Can you imagine?  Sixty days to hear why your baby died.  To me, this seems like a very long time for a bereaved family to wait to hear any explanation.  I am trying my best to be patient. 

Today, I had my hair done.  At times when you feel absolutely horrible on the inside, sometimes it helps to look good on the outside at least!  Not to mention that any good hair stylist is a great listener and part psychologist.  In my case, I also have a stylist who is deeply religious.   So, it was a good experience all around. 

For the time being, I am going to try to go easy on myself.  I am not going to hold myself to my usual standards for efficiency and busyness right now.  I am going to relax over the weekend, get rest, read, spend quality time with those close to me. 

Anger and frustration

Well, it seems like I am experiencing a little anger, after all.  Not anger at any one individual.  I am becoming increasingly angry about how the issue of pregancy loss, both miscarriage and stillbirth, seems to be neglected and devalued by our society at large, including the medical profession.  I am wondering just how many babies have to die, and how many families have to endure untold pain and suffering, before due attention is paid to this issue.  In a society of our wealth and resources, you would think that a little more could be directed at saving the lives of our unborn children and protecting the health of pregnant women.  In the past few weeks, I have learned more than I ever wanted to know about these issues.  I have been astounded to learn how common certain disorders that may contribute to pregnancy loss are.  In particular, I have to wonder why women aren't screened for some of these risk factors preemptively.  How much could it cost?  I had to lose one child in an early miscarriage, and lose my unborn daughter at 31 weeks.  This earned me an evaluation for risk factors for pregnancy loss.  Isn't that too high a price to pay?!  I now have to wonder if my daughter's death could have been prevented with more extensive screening for these risk factors. 

I recently learned of a website called "Faces of Loss, Faces of Hope."  See their link on the right side.  The women featured on this website share their stories to raise awareness of issues related to miscarriage and infant loss.  I give these mothers so much credit for sharing their private heartbreak in a public forum.  Other women, and men too, need to hear about these issues, which are all too common.  Please consider visiting the website and reading some of the stories.

In spite of what I believe to be legitimate anger and frustration, I constantly remind myself that nothing can bring Angeline back.  Time is passing.  It has been more than two weeks since I held her and said goodbye.  We received her ashes and brought her home.  The prevailing wisdom among many of those around me seems to be that it will help me to get my mind off of this a little.  I have tried following my own advice from my last post.  We have gotten out of the house now and then, tried to distract ourselves in various ways.  I still feel that I could think about what has happened every minute of the day, but I know this won't change anything.  It is time to try to pick up the pieces and start putting my life back together. 

Remembering who you were, acknowledging who you have become

I think that there is definitely something to be said for immersing oneself completely in grief.  For some period of time, I think this is the right thing, and the healthy thing to do.  After a loss, sometimes being consumed by grief and not running away (or trying to hide) is the only way that the new reality sinks in.  My new reality: "my baby died," and "yes, I have a child, she died."  As horrible as it feels to say these things, it is the truth and it is now a part of who I am.

But what about the rest of who I am?  What about all the things that made me who I was before I became pregnant with Angeline?  As one of my girlfriends recently reminded me, those things are important, too.  The sad fact is that nothing can bring my daughter back, nothing can change what has happened.  While respecting my loss and experiencing a period of grief, we must somehow pick up the pieces of our shattered expectations and move forward.  Not move on, exactly, but move through.  Part of moving forward will be trying to take an interest in things I cared about before this terrible tragedy happened.

To be honest, it is hard to force myself to feign interest in going to dinner with a friend.  I am not too hungry, and I don't know what we'll talk about.  I will go, however, because my friendships are still important to me, just as they were before - probably even more so than before.  I realize just how valuable good friends are; relationships need to be cultivated and should not be neglected.

The same is true of one's relationship with their partner.  In Dr. Davis's book, she says, "Remember that before you were parents, you were friends and lovers."  Even though we are both hurting very deeply, I think that we need to try to take an interest in things and activities we previously enjoyed together.  We need to remember what we loved about each other in the first place.

I will be going back to work soon.  Work has always been a large part of my identity, since it took so long for me to train to become the professional that I am now, and it consumes so much of my time.  I will be re-entering my work environment as a changed person.  I think that going back will help me to remember who I was before this happened.

So, in these next few days, I will be focusing on remembering who I was before while still acknowledging who I have become.

   

Where we've been

It has only been two weeks since our nightmare began.  It seems like much longer.  It was two weeks ago on that fateful Wednesday morning that I suspected something was wrong and went to the hospital for the ultrasound that would change our lives forever.

From the very beginning, I have tried my best to deal with this devastating experience in a way to minimize the collateral damage.  Even as I underwent my induction of labor, I started reading parts of the book "Empty Cradle, Broken Heart: Surviving the Death of your Baby," by Deborah Davis, Ph.D.  This book deals with the subject of pregnancy loss and infant death in an extremely sensitive and insightful way.   I considered the book's recommendations for affirming my baby and creating memories.  I was fortunate to be delivering at a hospital that has an excellent program in place for perinatal loss.  In addition to compassionate care from experienced Labor and Delivery nurses, the hospital protocol encouraged and helped me to acknowledge my baby, the loss of her life and to create tangible reminders of our experience.  After the delivery, I held her and took time to look at her delicate, lifeless body.  The nurses took pictures of me with the baby and the baby alone.  They created a keepsake box with various items such as her baby blanket, her pink hat, hospital bracelets, a small photo album and a CD of many other photos.  A photographer from Now I Lay Me Down To Sleep came in the morning; she created beautiful images that I already cherish.    

I have been so grateful to the many expressions of support and sympathy from family, friends and colleagues.  I received many calls, texts and emails even while in labor in the hospital.  From the time we came home, 12 hours after the delivery, we started receiving cards, flowers and food from our network of support.  My mom flew across country to spend the week with us.  Several of my girlfriends have been particularly wonderful - we have been through thick and thin in the past, and they have been there for me at this time I needed them the most.  My colleagues at work covered for me and encouraged me to take off as much time as I needed.  In the midst of our agonizing grief, I have not felt that we were alone.

We have had some very hard days.  The day we went to the mortuary to sign paperwork allowing our daughter's body to be released was very difficult and affected me deeply.  I chose an urn for her ashes:  "size appropriate for infants up to six pounds."  We still anxiously await results from pathology and autopsy.  We have no answers, to this point we believe she was a normal, healthy girl.

I have started attending a perinatal loss support group.  It meets on Tuesday evenings and is very well attended.  I have been impressed with how constructive this one hour session seems to be.  I plan to keep going and I expect it will help me significantly with the process of grief and eventual recovery.

We put away our baby things.  I viewed this as an act of hope - our little Angeline won't need these things, but we hope that someday we will use them for her little sister or brother.

We went for long walks.  We talked about how we felt.  Although we have different styles of coping, I think we are both doing as well as can be expected.

So, that's where we've been these past two weeks.

Senseless tragedies we can't control

It has been almost one year since the catastrophic 7.0 magnitude earthquake hit Haiti.  I remember at that time having a slight crisis of faith.  I had been to Haiti in the 1990's to volunteer in a children's hospital where many of the babies had HIV/AIDS.  I was so impressed by the faith of the Haitian people - in many cases, they would arrive at Sunday mass wearing the only dress clothing they owned, and kneel in the dirt to praise God for the blessings He had bestowed on them.  When the earthquake hit, I thought to myself, why would a loving God choose to strike these faithful people, who are already living in horrendous "third-world" conditions?  Of all places, why there?  I acknowledge that there may be a plan that we don't understand, or that God may act in ways that are mysterious to us.  That being said, it seems so clear that this a world devoid of justice and fairness.

With my own crisis, the loss of my daughter, I have not actually focused on "why me?"  I have long ago realized that life is not fair and that bad things frequently do happen to good people.  I don't think I had done anything wrong to "deserve" this.  As a matter of fact, it has seemed more an ironic twist of fate than anything else - such a rare occurrence, particularly unusual in a woman with no risk factors to speak of.

While I have been mourning my daughter's death these past days, once again I have been struck by another tragic event covered extensively by the media:  the critical shooting of Rep. Gabby Giffords, the murders of an innocent 9 year old girl and several other bystanders, as well as many individuals wounded by an apparently mentally unstable gunman.  The occasion had not been a high profile event, these were not individuals who expected their lives to be endangered in front of a Safeway while attending a community gathering.  How unexpected, how unimaginable.  Of course I cried hearing the little girl's mother speak of her profound sense of loss - a loving mother subjected to heartbreaking pain needlessly.

More than ever, I now realize that I need to resign myself to the fact that though we try to control and direct our lives, we have little control over what happens to us.  At times, when my faith was particularly strong, I would say, "it's not my plan, it's His plan."  To a degree I still believe this, only I have stopped trying to make sense of anything that He does.  If there is a plan, I don't believe we have the capacity to understand it.

When I lived in Connecticut a number of years ago, I attended a church with a pastor I found especially inspiring and insightful.  With reference to the 23rd Psalm, our pastor spoke at length regarding "the valley of darkness."  He told us that valleys are simply part of the human condition.  I have quoted him many times as saying, "you're either in a valley, coming out of a valley, or about to head into a valley."  More than ever, I realize that this is certainly the case.  So I will keep walking, hoping to head out of this dark valley.

Introduction

Never did I expect that I would become a "blogger."  About anything.  Least of all did I expect that I would be describing a journey following the loss of my first child, a daughter we named Angeline.

2010 did not start out as a good year for us.  Adrian and I actually experienced a very early miscarriage in late January, probably about 7 weeks or so, but I had not yet had a first trimester ultrasound, so we can't really be sure.  At the time, this was difficult.  I felt there was a cloud of sadness hanging over us.  On the other hand, I believed that there was a good reason (so to speak) that this pregnancy "didn't stick."  Usually, early miscarriages like this are the result of genetic problems or implantation problems.  I was upset and very disappointed, of course, but recovered reasonably quickly.  While following my doctors orders to wait a specified period of time before conceiving again, we took some time to enjoy what I hoped would be among our last trips as a couple for awhile - we took a trip to Hawaii in March, in April a weekend in LA, Santa Barbara in May.  By the time June rolled around, I felt we were ready to move ahead and try again.  Having read up on fertility monitoring and employing the wonders of modern home screening, I was hopeful we would conceive sooner rather than later.

I learned of my pregnancy in the very end of June.  To be sure, this was a wanted baby, a planned pregnancy.  I believed I was pregnant before actually seeing the positive test.  I just knew our efforts had been successful.  I was thrilled to see that second pink line!  My doctor had instructed me to contact the office when I did have a positive test, and she started monitoring my serum BHCG and progesterone levels, given that I had previous had an early miscarriage.  I had levels drawn every other day for about a week, and was reassured that everything was rising appropriately.  I remember the first ultrasound, and the beautiful little flicker of a heartbeat.  I was cautiously optimistic, but nervous about another first trimester loss.

It wasn't until I went to have my 12 week ultrasound and nuchal translucency study that I was even ready to share our good news with my parents.  I knew they would be overjoyed - their first grandchild!  I remember being so anxious about the NT, I was hoping and praying that it would be normal.  What a relief it was when I learned that it was perfectly normal.  That evening I sent my parents and email of the ultrasound pictures - the technician had drawn a little conversation balloon for the baby that said, "Here I am!"  As expected, my parents were ecstatic, practically more excited than we were.

From the very beginning, I was very careful to observe all the rules for a healthy pregnancy.  No alcohol, no caffeine, no soft cheeses, no fish with high mercury content.  I altered my pescetarian diet to include chicken.  I avoided hazardous exposures at work.  I exercised moderately until about 18 weeks and then kept active with long walks, etc., careful to stay hydrated and never to push myself too hard.  I stopped wearing a cellphone on my waistband.  I was cautious about all skin products and didn't even highlight my hair until well into my second trimester.  I would very rarely take any over the counter medications, and only those on the "safe list."  I carefully monitored my weight gain - not too much, not too little, just right.

The first trimester was uncomfortable, but not terrible.  I had some nausea from about 7-10 weeks.  I had the usual various GI issues, food aversions and generally felt sort of bloated and uncomfortable until moving on into the second trimester.  After that, I started feeling pretty good.  Actually, I felt very good.  I would even go so far as to say I was getting used to the whole thing.  At about 20 weeks, we found out our baby was a girl.  Originally, I didn't mind either way - all I wanted was a healthy baby.  Once I knew, I had so much fun picking out girly things for our daughter!  The third trimester I was still feeling great, my only physical issue was that of my rapidly expanding belly - it was getting hard to put on my socks and bend over to pick up things on the floor.  Otherwise, I felt fantastic.  I went for routine appointments with my obstetrician.  I think I was a pretty boring patient, which is good, of course.  I basically had no complaints.  All of my screenings were normal.  Each of my ultrasounds showed my baby was growing perfectly.

I had great fetal movement.  While reading in bed, I would sometimes get kicks so big my magazine or book would literally bounce.  I would impress Adrian with our baby's acrobatics.  He would tease me and tell me that she wanted some peace and quiet when I was talking too much.  Once while we were snuggling up in bed, she gave him a big kick in the back.  I felt certain she would end up being a very active child, maybe a dancer, maybe an athlete.  She was so full of energy and life.

In December, I traveled back to New York for a shower with family and friends.  It was just a little early - I was about 28 weeks, but I knew I wouldn't feel comfortable flying across country after the holidays.  I would be well into the 3rd trimester by then and planned on staying within a short drive of the hospital and my regular OB!

Adrian and I had a quiet Christmas.  We did not have family visiting this year.  We had dinner with my cousin and her husband on the 23rd.  We planned an outing on Christmas Eve, which was very nice.  We spent Christmas at home.  Adrian made omelets for breakfast and we watched "It's a Wonderful Life."  We exchanged gifts - from Adrian, I received a beautiful necklace with special significance.  The pendant has two circles of pave diamonds with a small circle of diamonds in the middle - to represent us and the baby.  He brought tears to my eyes.  We enjoyed the holiday and anticipated how next year would be much different.  Our baby could be crawling (or even walking!) by then.  I am so grateful for that happy time we spent on Christmas, enjoying our baby and our plans for the future.

A few days later everything changed.  I will close with a copy of the email I sent to our family and friends in early January 2011.



As you know, Adrian and I were happily anticipating the arrival of our baby girl around the first week of March.  As you have heard, this past week we experienced a horrible turn of events.  Many of you have had some updates from my parents, and I wanted to respond to your kind messages myself and share some details of our experience.  


I was 30w 5d into what has been a completely normal, healthy pregnancy.  All of my screening tests had been reassuring and there had been no indications of problems whatsoever.  I had been seen in my OB's office on Tuesday afternoon, where normal fetal heart tones were documented and my exam right on track.  I decided to spend the evening relaxing, we had a light dinner at home and watched a movie.  I awoke early Wednesday morning and thought I noticed a decrease in the baby's movement.  I became increasingly concerned when I was unable to locate fetal heart tones on my home monitor.  I called my OB and was instructed to report immediately to the hospital for fetal diagnostic testing.  By this time, I was very concerned, but not in complete panic, as I felt certain there must be some explanation, such as a change in the baby's position.  I simply did not believe that something would go so wrong at this late date.  


Our nightmare began when the high-risk OB performed an ultrasound - within seconds, I knew for certain that our baby girl had died.  I will never forget the moment that he turned the monitor toward me to see the absence of the heartbeat with my own eyes.  We were told that the ultrasound findings suggested this was a very recent event, likely within the previous 12 hours.  There were no abnormalities seen otherwise, and I was told this was possibly an "umbilical cord accident."  We were instantly devastated.  


We spent a difficult day at home waiting for my OB to return from her holiday travels.  I went in for the induction of labor late Wednesday evening.  The epidural was perfect, it went in very smoothly and was very effective - I had it in for many hours and never felt any significant discomfort from contractions or the delivery.  The induction took hours - the whole day Thursday, in fact.  Of course, Adrian was there and my cousin came in early in the day and stayed with us until the end.  Several of my friends and colleagues came by during the day on Thursday, everyone showed so much love and support.  My phone never stopped alerting me with text messages and calls from friends / family from back East expressing sympathy and support.  While it was difficult to spend so much time in this process, I think it was probably helpful in terms of helping us to psychologically adjust to what was going on.  I was finally ready for delivery just before midnight.  My OB arrived within 15 mins of our call.  She was wonderful, in such a horrible situation, she tried to make everything as easy and painless as possible.  


I finally delivered just after midnight on 12/31.  We named her Angeline, as she will be our angel baby.  The delivery was quick and painless, there were no complications.  There was no obvious abnormality seen at the time of delivery, except for a short umbilical cord, according to my OB.  She also noted it was slightly difficult to draw the cord blood and there may be a clot.  Of course, the placenta, cord and baby will be examined by the pathologists. 


I did all of the things that are suggested in this situation - I held the baby, we took pictures.  The hospital has a protocol where they prepare a "keepsake" box with various items, and there is an organization called "Now I Lay Me Down to Sleep," which sends a professional photographer take do photos that are airbrushed and touched up to remove signs of bruising, etc.  I told the baby that she was wanted and we loved her, and that I didn't know why she had to go, but that we would miss her very much.  I had the hospital chaplain come in and say a blessing for us. 


I was discharged at noontime on 12/31 and I have been recuperating here at home.  We are doing as well as could be expected.  

We would like to thank all of you for the many expressions of sympathy, love and support you have given us.  As sorrowful a time as this is, we are overwhelmed by the goodness of the wonderful people in our lives who have done so much to ease our pain.  Thank you all.  We love you.