Tuesday, August 27, 2019

From August to August

I learned I was pregnant the first time on August 10, 2018. I was four weeks along then, and had two long weeks to get through before my first doctor's appointment to confirm the pregnancy. It would be another two weeks after that first appointment before I would learn that I was having a missed miscarriage; I had a D&C at 1 day shy of 9 weeks, on September 13, 2018.

For my second pregnancy, I again saw my first positive home pregnancy test at four weeks, on May 5, 2019. Soon after, my doctor brought me in for early hCG blood draws to ensure that the pregnancy was progressing appropriately this time. At 4 weeks 2 days, my hCG was 2,836 (rather high for an initial draw); two days later it had more than doubled, and was now at 7,420! It was a good sign, and I was scheduled for my first ultrasound at 5 weeks 4 days. Baby was measuring a few days early (6 weeks 1 day) and had a confirmed heartbeat!

Thankfully, my second pregnancy has continued to follow this much different trajectory than my first. I had another ultrasound at 6 weeks 5 days, another at 8 weeks 4 days, another at 11 weeks 4 days, and another at 16 weeks 2 days. (Being considered "high risk" has its perks.) Baby has consistently looked healthy, measuring a few days ahead at every single appointment. :)

Now, it's August again, a year since my first pregnancy began, and I recently passed the halfway mark (20 weeks) in this second pregnancy. I'm due in early January 2020.




During my first trimester (May-July 2019), I had a few people ask me if I was more nervous/less excited this time, given that my first pregnancy ended in loss. I guess people supposed that I'd be more guarded with my emotions, knowing how a pregnancy could end. But the truth is, I wasn't. Not during the first trimester, and not now that I'm in the second trimester either.

I was actually quite worried about miscarriage during my first pregnancy - almost as if I somehow knew it would happen, even though I really had no reason to suppose it would. I tried to pretend I wasn't afraid, and even took specific steps (like telling close family and friends very early) to try to help myself feel less worried and get more excited about it.

This time, if I didn't tell people quite as early (or didn't seem as excited when I did), it's because I didn't feel as anxious. I let myself get excited on my own - and so didn't need other people's excitement to help me get there. Nearly right away, I started working on a baby registry. I bought cute baby clothes (probably too many). In June, my husband and I installed custom shelves and hanging rods in our nursery closet. (And yeah, I did end up telling several people early again after all.)

I still knew the chances of loss - perhaps even more keenly than I had during that first pregnancy. The difference was that last time knowing those chances had made me anxious and afraid... and this time, they didn't.

At least 1 in 4 pregnancies end in miscarriage. If you include pregnancies that end before a person might know they're pregnant (eggs that were fertilized but never fully implanted in the uterine lining, cycles that end with an on-time or only slightly-delayed period), it's probably closer to 1 in 2. The truth is that a lot has to go exactly right for a pregnancy to happen. If anything is even slightly off with the environment inside the uterus, or the genetic code of a fertilized egg, the pregnancy won't be viable and will end in miscarriage. Most of the time these things can't be controlled; there is nothing that can be done to stop it.

My first pregnancy, I tried to do everything right. I ate only the "right" foods, and I did my best to hit my blood sugar targets (even though I had no mealtime insulin to help me achieve that lofty goal). I worried about paint fumes and household chemicals and driving over potholes (which is a frequent occurrence in Michigan). I had a list on the notes app of my phone titled "Things to Avoid While Pregnant" that I compiled and frequently consulted. I knew that most miscarriages couldn't be prevented, but still hoped I would be able to stack the odds in my favor. I couldn't.

So when my second pregnancy began, I didn't worry so much. I obviously still followed (and continue to follow) the general eating guidelines - no raw meat or fish, no unpasteurized cheeses - but I allowed myself to eat cooked hot dogs and sausage, and put Caesar dressing on my salad, which I'd denied myself last time (the first because of "poisonous nitrates", the second because of the possibility of raw eggs, even though that possibility is basically zero for any Caesar dressing you buy in the grocery store). If the bathroom counters or shower needed to be cleaned, I cleaned them without worrying about breathing in chemicals for a few short minutes. And not once did I consult my "Things to Avoid While Pregnant" list. As a result, I was a lot less anxious those first few weeks of my second pregnancy. I'd freed myself from the unrealistic expectations that I could control how things went.

I was less anxious for other reasons too, including the logical fallacy that I'd already had a miscarriage, and so thought it less likely that I would have another. After all, if 1 in 4 pregnancies end in miscarriage, wasn't I now "due" an average of 3 healthy pregnancies before I had to worry about miscarriage again? It doesn't actually work like that of course... At best, the events are independent, meaning the chances are the same every time. At worst, the first miscarriage wasn't just a "fluke" after all, and was caused by an underlying problem with the potential to recur again and again, meaning the chances of future miscarriages would be higher, not lower. But there's logic, and there's feelings, and part of me just felt that my second pregnancy was bound to go better than my first. I knew it had no real basis in fact, but I let myself believe that it did, because believing it made me feel better.

It also helped that my second pregnancy immediately felt different than my first. I had early symptoms this time (sensitive, tender breasts) that I never felt until AFTER my D&C last time; there were still other symptoms that I had with my first pregnancy (lower back pain, GI distress, and muscle fatigue) which were significantly lessened the second time around. Different symptoms don't guarantee a different outcome of course - but it's easy to fall into that line of thinking, and once again, I didn't discourage myself from doing so. If believing that was true made me feel better, why not believe?

It also likely helped that my doctors brought me in sooner for blood work and an early ultrasound, and that everything looked great right from the get-go - and continued to look great. Every time I went in for another ultrasound and saw reassurance on the screen that everything was still going well, I felt such relief. I mean it when I say I didn't spend much of my first trimester this pregnancy worrying about having another missed miscarriage... but that doesn't mean I never worried. A few hours before each of the first few ultrasounds, it would all come back to me - being in that room with the ultrasound tech and learning the bad news. In those moments, it was hard not to worry that it would all happen again. But then I'd go in for the appointment and NOT hear bad news, and that relief would buoy me for weeks - until a few hours before my next ultrasound, when last-minute doubts and anxieties would rear their ugly heads again.

But I think the biggest reason I was less afraid this time was because the possibility was less unknown. I knew what it was to have a miscarriage. I knew what it entailed. And I knew that it was survivable. Framing it that way doesn't completely stop you from worrying that it might happen again, but it does help - A LOT. I knew I would be just as devastated (perhaps even more so) if I had a second miscarriage... but I also knew that I would recover. Now that we'd successfully gotten pregnant twice, both times within a few months of trying, I could say with more confidence that we didn't have fertility problems. And I had faith that we would keep trying - that we could and would get pregnant as many times as we needed to (or find an alternative, if necessary), and that eventually we would see through our dream of becoming parents.

So whenever the possibility of miscarriage crosses my mind (or stillbirth, which it would be considered now, after the 20 week mark), I try not to dwell on it long. I know that if it happens again, it would only be a temporary setback (even though it wouldn't feel like it at the time). I know that I'm resilient and strong and capable of moving on and trying anew. And I also know that I have a support system that would help get me there.

Nearly a year after my miscarriage, I still think about it a lot. Not the anxiety, fear, or grief I felt - but the love and support I was surrounded with. I remember my husband reading me funny tweets from his phone to keep my spirits up while we were waiting in the pre-op room before my D&C. I remember the bouquets of flowers my parents and in-laws sent. I remember the doctors and nurses being kind to me, and the emails from work that I could "take all the time I needed" before returning. And I remember the outpouring of support I received from people (many whom I hadn't talked to in years) on this blog and on Facebook, when I "went public" with the story of my miscarriage on Pregnancy and Infant Loss Remembrance Day last October.

I remind myself of all those things whenever there's something to worry about... Because while it's true that I didn't worry as much about another missed miscarriage, I definitely worried about OTHER things instead during that first trimester.

In the very beginning (before my first ultrasound proved otherwise), I worried that my hCG levels were TOO high, and that it might mean a molar pregnancy - which would result in its own kind of miscarriage, likely requiring a delay of several months before we'd be cleared to try to get pregnant again.

Then, my early ultrasounds found a mass in my right ovary, which I was told was "probably" a cyst (a benign and common occurrence that happens in about 10% of pregnancies) - but which "might" be a heteroectopic pregnancy instead (a much less common occurrence, happening in only 1 in 300,000 natural pregnancies). A heteroectopic pregnancy would mean I had two fertilized eggs (twins) but that one implanted improperly in my fallopian tube or ovary, instead of in my uterus. It would mean that the inviable ectopic pregnancy could rupture and destroy my fallopian tube, impacting my future fertility. And it would also probably mean careful surgery to remove the ectopic pregnancy without harming the healthy pregnancy in my uterus - a surgery which, even if done correctly, could result in my healthy pregnancy miscarrying, as happens in about 30% of cases of abdominal surgery during the first trimester. I tried not to worry about the possibility too much (and the statistics were very comforting here, implying that a corpus luteum ovarian cyst was MUCH more likely), but because there was visible blood flow around that ovary and my hCG levels were slightly elevated, the ultrasound techs and my regular OB doctors kept insisting that a heteroectopic pregnancy "couldn't be excluded," even after examining the cyst on two different ultrasounds. Finally, at 8.5 weeks, I got a second opinion from Maternal Fetal Medicine (MFM); they firmly concluded that it was only a cyst after all.

There were other medical scares too (all of which concerned my health, never the baby's). During a breast exam at my OB's office, I was told that they'd felt a possible lump, and only after a full ultrasound of both breasts was the possibility of breast cancer ruled out. And a few weeks later, towards the end of my first trimester, an EKG that MFM ordered to check my heart functionality came back "borderline" and had to be followed up with an echocardiogram - a full heart ultrasound. Those results also came back with good news, concluding that I had no genetic heart defects after all.

To get through the anxiety that all these potential complications brought, I again turned to what I knew: that I was resilient and strong, that I had a wonderful support system, and that one day, somehow, we'd be through all the setbacks and see our dream realized.

These weren't new realizations - I actually wrote a letter to myself last August that suggested all those things - but now I had the evidence of my September miscarriage to back up that hypothesis.

This is what I wrote on August 17, 2018, addressed to myself to open one year in the future (August 17, 2019):

"I'm currently 5 weeks pregnant and about to tell Mom and Dad the news that they're going to be grandparents. I'm nervous about telling them (telling anyone, really), because even though the chance of miscarriage goes down every day this pregnancy continues, there's still about a 17% chance of miscarriage right now (at least, according to this site) - which is 1 in 6, a roll of the die. I haven't even had the pregnancy medically confirmed yet (and won't until my first appointment/ultrasound in a week) - so I only know I'm pregnant at all from a handful of mild symptoms and the two positive home pregnancy tests I've taken... I'm hoping that telling some people will help make this all feel a little more real. But I also don't want to feel responsible for dragging others through the roller coaster of emotions (up, then back down) if (heaven forbid) something were to happen and this pregnancy doesn't end up 'sticking' after all. I want to have a support system I can lean on if that were to happen - but I also feel guilty enlisting people to be that support system, especially if they don't want to be. (Chances are they DO want to be - but you know me. Always doubting that people might actually want to help me.)

"I'm anxious about a lot of things - if and when certain pregnancy symptoms might appear, whether or not this pregnancy will 'stick,' what my blood glucose is going to do over the next crazy 8 months. So I'm writing this letter to future-me so that I can at least find reassurance in the future, even if I can't now. Future-me is probably laughing right now reading this, remembering this anxious feeling from a year ago but knowing that everything turned out ok and I delivered a healthy baby in April. You have your own struggles now I'm sure, struggles so immediately pressing that all the worries from early pregnancy must seem very distant. You've been recovering from giving birth and adjusting to motherhood. You have a 4 month old, for crying out loud! I can't even fathom right now. But at least you can read this letter and find reassurance that you made it through everything you were worried about this time last year - which means you can also make it through whatever aspects of parenthood have you worried now.

"And if you're reading this and AREN'T bolstered by the knowledge that everything turned out ok - because something happened along the way and this pregnancy turned out not to be viable - then I hope you find reassurance in this letter anyway, in remembering that at this time last year you were worrying about 'roping people into' being your support system (a worry that likely seems frivolous now, after seeing how that support system helped you after all), and imagining miscarriage as the worst thing you could think of (which now you know you were able to survive)... I hope all your wishes about this pregnancy and this baby and motherhood have come true. If they haven't, I hope that you haven't given up on them. I really do believe that I will be an incredible mom - which means that you are too (already, or will be soon)."

Turns out I didn't really need to reread those words for reassurance this month - because I'd remembered the gist of what I'd written, even without seeing it over the last year.

It's funny - if you'd told me the week immediately before or after my D&C in September 2018 that I would one day in the not-too-distant future look back on that time for solace, I would've had a hard time believing you. What solace is there to find in loss and grief? But the me-before-miscarriage understood how helpful that might be, and the me-of-early-2019 employed that tactic religiously. Throughout the cycles when we were trying to get pregnant again, and then in the early months of this pregnancy, I frequently reminded myself of what I had already survived, as proof that I could do it again. I reminded myself of my strength and resilience - and the strength of my relationships.

By the time I opened that August 2018 letter a couple weeks ago and re-read those words, I was already well into my second trimester - out of the "danger zone" when most miscarriages are likely to happen. I'd already told everyone about my new pregnancy, even posting the happy announcement on Facebook.

But there are still things I could be worried about. (There always are.) I don't know what my third trimester will bring, and what (if any) complications my diabetes might cause. I don't know how labor and delivery will go. I don't know if parenthood will be what I imagine it to be, or how easily I'll adapt to the unique challenges that will bring. But I'm not going to heap unnecessary suffering on myself and deny myself the current pleasures of hope, excitement, and joy. Instead of living based on my fears, worrying about what might go wrong, I'm choosing to live based on my hopes and dreams, letting myself get excited about what could go right.

As Hagrid said in J.K. Rowling's Harry Potter and the Goblet of Fire, "No good sittin' worryin' abou' it. What's comin' will come, an' we'll meet it when it does."

Tuesday, August 20, 2019

Multiframe Set - "Card Sharks"

My last blog post was about creating these three 5x7 watercolor paintings. Today I'm going to show them off - finished, framed, and ready to hang! You can purchase this framed three-in-one set here in my Etsy shop.








It can be hung in any direction, vertically or horizontally, as desired for space or design reasons. You can purchase this framed three-in-one set here in my Etsy shop.

Wednesday, August 14, 2019

"Card Sharks" 5x7 Watercolor Paintings

I recently finished three 5x7 paintings for a new framed watercolor set. The first painting was all black, the middle painting black and red, and the final painting red. I named the set "Card Sharks" since it reminded me of the suits of a standard card deck - both in the design of the patterns, and in the colors.

First, as always, I traced the patterns onto watercolor paper, and then taped them down to my surface so they would stay flat while I painted.




Then I painted the black watercolor, using my Ivory Black watercolor pigment.






Next, I moved on to the fun middle painting, which involved blending black and red paint using a wet on wet technique.







Finally, I did the last painting, which was all red.





Here is the finished trio:





I will have another blog post soon with pictures of these watercolors as a complete framed set, available for purchase here on Etsy.

Thursday, August 8, 2019

Spring Flowers

In addition to spring bouquets (see my last post), I also took several photos recently of the flowers naturally growing in my yard. My tulips were back this year, as well as the bush and tree blossoms in my back yard. I also found some lovely wild violets growing in the grass, so I snapped some pics of those, too!












All of these photos were taken in May. I planted my tulip bulbs in fall 2017, so last year (spring 2018) was the first time I saw them. They were mostly striped hybrids last year, red and yellow both on the same flowers. This year when they regrew there were solid red and solid yellow tulips instead! So interesting! :)

Friday, August 2, 2019

Spring Bouquets

I'm several months behind on posting flower photos on here, so today I wanted to take the opportunity to finally share some photos I took of spring bouquets I received in April.

One bouquet was from my husband, as a surprise pick-me-up when we were approaching the due date my miscarried pregnancy would have had (April 19) if it had gone to term. Two other bouquets were gifted to me by my parents and my uncle on Easter, when I hosted my family for Easter dinner at my house.

All were beautiful spring flowers, and lovely colorful bouquets, which I loved taking photos of! Here are some of my favorite photos: