Showing posts with label mental health. Show all posts
Showing posts with label mental health. Show all posts

Wednesday, December 30, 2020

2020 Art In Review

I created only ten pieces of art in 2020 (a far lower number than the 98 I did in 2019!). This year's art was also all on a small scale, with all ten measuring 8"x10" in size. Nine were colored pencil drawings that were a part of my "floral attributes" series, and one was a watercolor I painted as a gift for a friend. I knew I wouldn't be nearly as productive as I had been the previous year (and indeed, the reason I made SO much art in 2019 was because I knew I would be busier in 2020, and I wanted to save back some 2019 artwork to fill in the gaps for this blog this year) - but looking at that number ten is still rather shocking at first glance. Ten? Only ten? Sure I was busy, but I definitely had time to do more than 10. Right? 

But when I look at previous years that saw me make only ten (or fewer) pieces of art in the year, it starts to make more sense. 2011, 2012, and 2013 were all also low-output years. These were the three years immediately after I graduated with my BFA from EMU. I was 1) recovering from a bit of an art burnout, 2) focusing much more on graphic design (trying to find a local graphic design job, and also trying to start an invitation design company), and 3) planning for my wedding and our first househunting/home-purchasing/moving adventure.

2020 ticks a lot of those boxes as well. I went really hardcore in 2019 to pump out lots of art, so a bit of art burnout was likely there. 2020 also just had a lot of LIFE burnout. It was hard for ALL of us to be productive this year, with all the anxiety-spiking news making headlines. When you're weighing heavy pros and cons of everyday decisions (Is it safe to go to the grocery store? Is it too risky to visit family?) day in and day out, and your adrenaline is kicked into higher gear - and stays there for months on end - it's hard to focus on ways to channel creativity into productivity. Add to all that becoming a parent for the very first time, and prioritizing caring for our newborn daughter and trying to figure out what to do with her every day in a world where a lot of usual options were suddenly unfeasible... and then also deciding to move, and thus embarking on another househunting/home-purchasing/moving adventure (this time all in the midst of a pandemic no less) - and it's easy to see why my art output was a bit on the skimpy side this year.

I don't bring all this up to self-shame. In 2011-2013 I absolutely shamed myself for my lack of productivity - but I've grown since then, and I'm trying to be less of a perfectionist, and less hard on myself. I'm actually quite proud of my 2020. I accomplished a lot, especially all things considered; it's just that most of those accomplishments weren't art-related. And that's ok. That's the way it is sometimes, when your work is in a creative field. There will be ebbs and flows to your commissions and opportunities, and also ebbs and flows to your work habits and priorities. After 2013, I really prioritized art again, and I turned around those low-output years, coming up with plans for entire series of artworks - one of which I'm still working hard and seeing through. And after this year, I can turn around that low-output again. I have no doubt I will create more art in 2021, after we finish moving in to our new house and I get my new studio set up.

And the art I did work on this year? I'm really proud of it all. Here are 8 of the colored pencil drawings I finished this year (the 9th one I haven't posted on this blog yet - something to look forward to for a 2021 post!):









I also had a lot of success at Rochester Art Market at the Paint Creek Center for the Arts and on Etsy this year, selling notecard sets. My Great Lakes notecards continue to be most popular - but I've sold other notecards as well, especially those in my floral and rainbow alphabet series.





Head over to my Etsy shop to see all the notecard varieties I have to offer! And keep an eye out for some changes coming next year - I have a lot of new notecards on the way soon, featuring drawings from my floral attributes series!

Sunday, November 22, 2020

Thanksgiving

It's Thanksgiving week! Since I have no new art to show you (see my previous post about moving), I thought I'd take some time to list all the things I have to be thankful for this year instead. I know for many 2020 has been a really rough year, in many ways - and I feel very fortunate to have so have so much to be thankful for in such a bleak time.

The year started with the birth of my daughter on January 1st. What a way to start the year! It has been amazing these last ten and a half months watching her grow. From nursing to pureed foods and sippy cups, and now to eating the food off our plates; from barely being able to lift up her head to learning how to roll and sit and crawl and stand; from sleeping constantly to never wanting to sleep at all (why sleep when there's so many things to learn, so many rooms to explore, so many ways to play!) - she has been a constant source of wonder and joy throughout 2020.

On a similar note, I am also so thankful for my husband, who is the best dad to our daughter. The pandemic meant all of his classes for his master's program went fully online in the spring; once he found a job and started working full-time again, that was also remote. I love having him home so much, especially while our daughter is so young; even if he's working, he's still close enough that he can join us for walks around the neighborhood or a bit of playtime during his lunch break. He has gotten to watch her grow just as intimately as I have, and they have a wonderful bond. It's also been amazing for me, to have someone around to help get her down for naps and bedtimes when she just refuses to sleep, and to share in some of the daily stresses of parenting a baby.

I am thankful to have spent the majority of this year in Rochester Hills, which has so many great outdoor spaces. Over the summer, when we were bored staying inside our house but didn't feel comfortable taking our daughter to all of the places I'd once imagined taking her during her first year (to the library, and to stores, and to the zoo, and to anywhere else fun I could think of), we still had plenty of opportunities of places to go. We visited several nearby parks and took her on walks (in her stroller or in a baby carrier) along the Clinton River Trail, which was a lot of fun for her and our dog, and great fresh air and exercise for all of us.

I'm grateful that my husband was able to find a job he's really excited about, working for a non-profit he's really excited about, and that his new employers value his health and are taking this pandemic seriously. I'm also grateful that we were able to find a house we love in a neighborhood we love in Ann Arbor, and that we have the time to move there more gradually than we otherwise probably would if my husband wasn't working remotely and was already in the Ann Arbor office.

I'm thankful for our families - those who have been able to visit (once the stay-home order was lifted), entertain the baby, and help us move; and those who live farther away but still made time for countless Skype and Zoom calls to visit with our daughter safely (and virtually). They say it takes a village to raise a child, and this pandemic has isolated many from their villages; I'm so appreciative of the efforts made to make sure that wasn't our fate.

Monday, April 20, 2020

Diabetes & Pregnancy: The 4th Trimester

NOTE:
This post is a continuation of a series about managing my diabetes while trying to get pregnant and being pregnant. For more, you can check out these previous posts:

Diabetes Type 1.5/LADA
Diabetes & Miscarriage
Diabetes & Pregnancy: The 1st Trimester
Diabetes & Pregnancy: The 2nd Trimester
Diabetes & Pregnancy: The 3rd Trimester
Diabetes & Pregnancy: Childbirth

As always, these posts are not meant to be taken as medical advice, and merely discuss my personal experience with my specific diabetes. Everybody's experiences are different, and I am only speaking about mine.

***

My last post about my diabetes talked only a little about how my blood sugars and insulin needs changed after giving birth on New Year's day, January 1st, 2020. The focus of that post was more about managing my diabetes during labor and delivery, with just a few passing comments about changes that happened in those first few days after, while I was still in the hospital. This post will pick up where that one left off, continuing through the first three months postpartum - a time period some refer to as the "4th trimester," when a person's body readjusts to a state of no longer being pregnant.

Before becoming pregnant, I had only been on Levemir (basal insulin); I had no prescription for Novolog (mealtime insulin) until I first saw MFM at 8 weeks gestation. (MFM = maternal fetal medicine, the doctors and nurses who helped me manage my diabetes while pregnant.) My pre-pregnancy Levemir doses were 5 u. in the morning and 7 u. at night, for a total of 12 u. Over the course of 9 months of pregnancy, my total Levemir increased to 16 u., though we shifted when the bulk of it was taken, to 10 u. in the morning and 6 u. at night. I also started taking insulin with meals; by the end of my pregnancy, I was taking 12 u. Novolog with breakfast, 5 u. with lunch, and 6 u. with dinner. This increase in insulin requirements happens because the placenta causes insulin resistance - meaning that my body needs more insulin to process the same amount of blood sugar. (Though to be fair, I also wasn't eating the same amount of carbs during pregnancy as I had been before... Once I had access to mealtime insulin, I didn't need to be on a lower-carb diet anymore - and was actually told NOT to be, since growing a baby requires quite a bit of energy from carbohydrates. So I also was giving my body more blood sugar to process, as well.)

It was expected that after giving birth, my insulin needs would go back down to approximately what they'd been before getting pregnant. But I wanted to continue taking mealtime insulin after giving birth so I had a bit more flexibility with the amount of carbs I was "permitted" to eat - especially since I was planning on breastfeeding for the first several months of my baby's life, and would need similar dietary needs for breastfeeding as I had while pregnant. And that meant I couldn't just revert back to exactly what I had been taking pre-pregnancy, when I was taking enough basal insulin to cover post-meal glucose spikes as well. Still, those pre-pregnancy doses gave us a baseline to start at, with the expectation that it might take a bit of time to figure out exactly what insulin doses I should be taking for my basal insulin and at meals.

Taking all that into consideration, MFM recommended that I try 4 u. Levemir in the morning and 8 u. Levemir at night, for a total of 12 u. of basal insulin (same as I'd been taking pre-pregnancy). They also suggested that I try NOT taking any mealtime insulin at first, doing only 1-2 u. corrective doses if my blood sugar was high two hours after eating, until I better understood how much insulin it might be prudent to take with each meal. I wasn't super into that idea (it seemed like the first step toward ending up back where I was pre-pregnancy - only taking basal insulin and not having access to mealtime insulin), but they were the recommendations I brought with me to the hospital nonetheless, and what I planned to implement in the first few days after delivery.

That plan lasted one meal.

Other than a 2 am snack a few hours after giving birth, my first real meal postpartum was breakfast on January 2nd. Following MFM's plan, I took 4 u. Levemir and no fast-acting mealtime insulin. Three hours later, my blood sugar was at 197, and I took a corrective dose of 1 u. - which did the trick and brought me back down to normal ranges. Still, I was over that nonsense. Managing my diabetes at the hospital required jumping through a ridiculous series of hoops multiple times a day: reminding the nursing staff when to check my blood sugar (per their own protocols - I had my own ways of checking my blood sugar on my own any time I wanted), asking the nursing staff for access to insulin, having a doctor sign off on the dose, and waiting for the insulin to be brought into the room - all while my hospital cafeteria food grew cold as I waited. Taking a "wait and see" approach with every meal just meant even more of a hassle - a hassle I didn't need on top of everything else. We were dealing with my baby daughter's low blood sugar, treating her with glucose gel and formula, and trying to establish breastfeeding; I didn't want to be subjected to extra blood sugar checks in the middle of all that, making decisions to correct highs after the fact. It seemed easier to just take preemptive insulin and avoid the highs in the first place.

Of course, I was also still very much in the mindset of keeping a very tight control over my blood sugars - a mindset that it was hard to get out of. For the past year and a half, I'd tried to keep my blood sugars below 120 at all times - during my first pregnancy (which lasted 8 weeks and ended in miscarriage), during my second pregnancy (which was full-term), and during the months in between, when I started using my CGM and we were trying to get pregnant again. When you start thinking of anything above 120 as bad, 197 seems downright criminal. (Compare that to the typical recommendation for (non-pregnant) diabetics: keeping blood sugars below 180. If that's the goal, 197 doesn't seem nearly as off-target.)

There was also this: I expected to experience lows postpartum. I'd read that some diabetics struggle with low blood sugars when breastfeeding, and so had taken precautions to strategically leave snacks around my house in the places I planned to do a lot of nursing, just in case that became an issue for me. I also brought a lot of snacks with me to the hospital, for this same reason. So I felt more prepared (both mentally and literally) to deal with the possibility of lows than highs.

All of this meant I started requesting 1-2 u. of mealtime insulin with breakfast, lunch, and dinner (depending on what my blood sugars were before eating, and what exactly I was planning to eat). I suspected this might require a change to my basal insulin, since now my total insulin levels were likely higher than they needed to be - but I figured it'd be easier to take too much insulin and then treat with more snacks if I needed to, than to not be taking enough insulin, and need to add more - especially since I often had to wait at least a half hour (and sometimes as much as an hour or more) between my request for insulin and when the hospital staff would bring it to me.

Still, even with that extra mealtime insulin I started taking, I didn't experience a postpartum low until 6 am on January 4th. I was getting so little sleep (up all hours of the night trying to breastfeed or pump, and visiting my baby girl, who had been taken to the NICU for a couple days to monitor her nasal congestion, breathing, and jaundice levels) that I was often hungry and ate frequent snacks - my body's way of compensating for lack of sleep, I guess. I decided to run an experiment; the night of January 3rd-4th, I didn't eat any snacks after 10 pm. Finally, I saw the low blood sugar I was expecting. When the nurses came to check my fasting blood sugar, I was at 61; my CGM said 62. During my pregnancy, I only very rarely felt hypoglycemia symptoms; for my first postpartum low I again didn't feel any symptoms. The nurses brought me graham crackers, and I ate those before breakfast.

I was discharged later that day, even though my baby was still in the NICU. We were allowed to board in another hospital room closer to the NICU for a couple days. My insulin pens were returned to me, and I was once again able to manage my own diabetes, but we were still on the hospital premises until our baby was also discharged on January 6th. I knew from the "experiment" I'd done that I had to eat a snack at least once overnight - one of the times I was up anyway, nursing or pumping - or risk going too low. Alternatively, now that I had access to my own insulin again, I also had the option of adjusting my insulin however I saw fit, without having to run it by the hospital staff. I could choose to not take insulin with a snack or meal, and then more easily correct it after the fact, if I saw myself going too high. Or I could decrease my basal insulin, to compensate for the fact that I was taking more mealtime insulin than MFM had originally suggested.

At first, I continued to follow the insulin plan I had been doing (4 u. Levemir in the morning, 8 u. Levemir at night, and 2 u. Novolog with breakfast, lunch, and dinner), making sure to eat snacks in between meals when needed, and at least once overnight. I made it through the night of January 4th-5th this way with no problems. But the next night, my CGM urgent low alert went off before I ate my middle-of-the-night snack, and I found myself needing juice and a snack during one of the few chunks of time I'd been able to set aside for sleeping. A few hours later, when I woke up to eat breakfast, I was back down to 74 again - not low, but getting close.

I was beginning to understand that I was trying to keep unnecessarily tight control over my blood sugars. I didn't need to subject myself to occasional hypoglycemia in an attempt to keep my highs from getting too high; I wasn't pregnant anymore, and didn't need to stay below 120. Now, it was more important for me to avoid lows, rather than to avoid highs - especially if my body was still unaware of my hypoglycemia, showing no symptoms. What might happen if I was unknowingly low while holding and carrying around my newborn? I had to ease up on my blood sugar control to take better care of myself - so I could also take better care of her.

My daughter was discharged later that day, and we finally got to take her home. At home, I ran an even greater risk of hypoglycemia for two reasons: 1) I had access to a wider variety of food, including options with fewer carbs, meaning I ate fewer total carbs throughout the day than I had at the hospital, and 2) now that she was no longer in the NICU, she was under my and my husband's care 24/7, without help from the NICU nurses. It was harder to find time to eat several snacks throughout the day just to keep my blood sugars up, when I was responsible for every feed (no more supplementing with formula!). That night, my blood sugar was at 77 at 10 pm. I decided it was time to start decreasing my insulin; I took 6 u. Levemir instead of 8.

This was the right choice - my blood sugars stayed pretty steady within a good range of 70-140 over the next couple of days. I hadn't had another overnight low. Still, when I called MFM to discuss the change I'd made to my nighttime insulin, they recommended that I decrease it even further, going down to 4 u. Levemir at night. They also suggested I cut my lunchtime dose to 1 u. instead of 2 u. (Though, I admit - going through the whole process of using an insulin pen needle to take only 1 u. seems a bit silly to me... I usually choose to either not take any insulin, or to take 2 u., depending on what my blood sugar is before eating and what I plan to eat.) 

A few weeks later, I switched my care back to my regular endocrinologist, and he agreed with my decision to continue taking those doses (or near those doses, per my discretion) - so that's precisely what I've been doing since January 8th:
- 4 u. Levemir in the morning
- 2 u. Novolog with breakfast
- 0-2 u. Novolog with lunch
- 2 u. Novolog with dinner
- 4 u. Levemir at bedtime

This seems to be a good amount of insulin for me. There are times when I see slightly higher numbers than I grew used to seeing over the last 1.5 years - but those "highs" aren't too high, just higher than what I was aiming for when I was pregnant. There are also times when I have occasional low blood sugars. But both scenarios seem less frequent than I was experiencing when pregnant - my blood sugar in general stays steadier, with fewer peaks or valleys. Everything acts a little more predictably, and easier to control.

In fact, everything has gotten so much "easier" that I've stopped counting calories and carbs of the things I eat. I still try to eyeball portion sizes and guess how many carbs I'm eating, but I don't add everything together when I make a recipe. Maybe I've just gotten better at guessing what 40-50 g. carbs looks like, after meticulously counting everything for several months; or maybe it really is that my blood sugars are steadier even if my estimate is "off" and I'm closer to 30 or 60 g. It probably also helps that I continue to use my CGM (continuous glucose monitor) - I can see at a glance what my blood sugar is doing and if it's trending up or down, which in turn influences what I decide to eat for a given meal or snack.

When I started making this change, I thought I'd only do it for a couple months. Recording every gram of carbohydrates I ate was just too much to keep track of on top of recording nursing sessions and diaper changes. (The first I'm still keeping track of, so I know how often (and how long) my baby eats; the second we kept track of for only the first 3 weeks or so, to make sure she was having enough wet/dirty diapers). But as time went on, and my blood sugars still stayed within a good range, I decided to continue being "more lax" about what I was eating. 

Constantly counting carbs can start to feel like an eating disorder after awhile - even if it's done for a healthy reason, like knowing how much insulin to take. I find that it can really start to negatively impact how I feel about certain foods, leading to me thinking of foods as "good" or "bad" - and myself as "good" or "bad" depending on what I choose to eat. I want to model for my daughter how to have a healthy relationship with my body and food. I don't want her growing up thinking that some foods are "bad", nor do I want her seeing me obsessing over numbers and constantly adding up nutrition facts in my head to determine whether or not I can allow myself to eat something in that moment. I don't want to pass on disordered eating to her.

If/when I am pregnant again in the future, I will probably have to revert back to my hyper-vigilance, making note of everything I eat. Not only is it important to have tight blood sugar control during pregnancy - it's also a lot harder. Part of that is because the targets are stricter - but it's also just hard to keep up with the changes a pregnant person's body is going through. Eating 30 g. of carbs vs. 60 g. of carbs makes a much bigger difference, and everything seems to follow a much less predictable pattern, which makes simply "eyeballing" foods a lot more difficult. 

In fact, I may even have to revert back to recording what I'm eating once I stop breastfeeding, and my body once again readjusts to a new normal. My endocrinologist told me that I will likely continue to need only about 12-14 total units of insulin a day as long as I'm exclusively breastfeeding. Not only does nursing burn calories - it also creates another avenue for excess glucose to exit my body, in addition to the traditional avenue of urine. (For those who don"t know, the full scientific name diabetes mellitus actually comes from the Greek words for "sweet urine".) Of course, I don't want to give my baby excess glucose through my breastmilk - but the fact remains, in those rare times when my blood sugars are a little too high, I probably do... to the benefit of my own blood sugar, at the expense of hers. (Thankfully, my baby's pancreas is better equipped to handle that excess.) Once we start introducing solid foods in a few months and she starts breastfeeding less and less frequently, my insulin needs are likely to increase a little again. But for now, I seem to be doing okay without recording everything I eat, and I intend to continue doing it this way until my blood sugars show that that approach is no longer working. I'm hoping that, moving forward, keeping such careful track of my carbs will be a the exception rather than the rule - something I only do temporarily, when pregnant or going through a similar hormonal shift (e.g. menopause), or when I'm making a lifestyle change (e.g. weaning off breastfeeding, or if I suddenly decided to start training for a marathon or something - HA!).

Another thing I've had to readjust since giving birth is how I wear my CGM sensor. During pregnancy, I had so many problems with my CGM giving me false low alerts, or going entirely offline and being unable to register my blood sugar, that I started wearing it on the back of my upper arms instead of on my abdomen. (My growing baby bump made it hard to have enough available belly fat for the CGM, which is inserted into subcutaneous fat tissue.) For the first few weeks after giving birth, I continued to wear it on my arm - until my arm started giving me the same sorts of problems. My postpartum body now had plenty of belly fat to work with - and my arms did not, as my baby continued to grow and I spent much of my days carrying her and holding her. So I switched back to putting my CGM sensor on my abdomen instead.

There is one final aspect I want to talk about - the guilt and worry that comes with being a diabetic mother. Every time my baby has a health problem, I wonder if my diabetes caused it. When my baby had some trouble with nasal congestion and breathing in those first few days after birth, was it because of all the IV fluids I was given during induction - something that wouldn't have had to happen if I hadn't been diabetic? When she had jaundice - both in those initial days and over the course of the next several weeks, in what was ultimately determined to be "breast milk" jaundice - was it because I, a diabetic, was breastfeeding her? When her blood work came back indicating high liver enzymes for several weeks in a row, even after her jaundice had finally disappeared, was it because nine months in a diabetic womb, or months of being breastfed by a diabetic, or just an unfortunate combination of my "autoimmune disorder" genes, had somehow damaged her liver or some other liver-adjacent organ (such as the insulin-producing pancreas)? 

We all have predispositions we might pass along to our children, and things that we've experienced that we want to see our children spared from - but from my perspective, being diabetic seems to amplify those worries. I'm not just worried about passing along some bad genes or less desirable habits - I also worry what the physical environment I'm exposing my daughter to. Hopefully as she gets older - once she has spent more time outside my body than inside of it, and as I wean her off my breastmilk someday - her body will feel less connected to my own, and those worries, at least, will start to fade. Then my diabetes and the choices I make for how best to manage it will only affect my body, my health - and not also hers.

Tuesday, October 15, 2019

Say the Word

Trigger warning: Discussion of miscarriage and pregnancy.

***



It's hard to believe it's already been a year since I "went public" about my September 2018 miscarriage, but it's true - once again it's October 15, Pregnancy Loss Remembrance Day. And while this one obviously feels different from the last - thanks both to the passage of time, which dulls all grief, and to the fact that this year I'm pregnant with a healthy pregnancy - I do still have some things to say about pregnancy loss, and my experience in the months that followed mine. Today seemed an appropriate day to share those thoughts.

Throughout the fall and winter immediately following my miscarriage, I had a lot of people reaching out and checking in with me, throughout my Facebook post, my blog, private social media messages, texts, emails, snail mail cards, phone calls, and in-person conversations. These efforts made me feel loved, listened to, and so lucky to be surrounded by such a wonderful support system.

And yet, there was something about many of those interactions that I found curious (and, if I'm honest, a little annoying at times) - something I hesitate to bring up for fear of seeming ungrateful:

People really don't like using the words "miscarriage"* or "pregnancy loss." In fact, they often go frustratingly out of their way to avoid them, using all sorts of superfluous and downright mystifying phrases instead.

Over those several months, I heard my miscarriage referred to as - and this is a non-exhaustive list - "that time" and "last fall" (as if autumn is inherently a challenging time of year), "the pain and difficulty you went through," "that thing that happened to you, which I read about on your blog," and even the ultra-vague "recent events." (That last one particularly confused me, as it was said to me in February - an entire five months after my miscarriage. If it weren't for other context clues, I wouldn't have had any idea what they were referring to.)

Then there were other people who just trailed off in the middle of a sentence, unable to think of a synonym for the word they were desperate to avoid: "How have you been doing since...?" or "I know someone else who also had a... you know..."

It was hard to ignore the pattern, and it was hard not to take it a bit personally. When it happens time and time again, with a dozen different people, you begin to wonder: Is it something about me? Are they pitying me? Do they think I'm "too fragile" to hear them use the actual word? It's not a great feeling.

At the very least, their avoidance signaled to me that they were uneasy talking about it - and that put me in a bit of an awkward position. Whether they were asking me how I was doing because they felt socially obligated to, or because they genuinely wanted to know, they hardly encouraged me to give them an honest answer or start up a lengthier conversation when the topic appeared to make them so uncomfortable. I often ended up giving the answer it seemed they wanted to hear ("I'm doing fine, thanks for asking") and leaving it at that. They got to feel good about reaching out, but I ended up feeling rather alone.

(This isn't to say I needed or wanted to talk about my miscarriage all the time; I usually didn't. But there were times when I would've liked to know the option was there if I wanted to talk, and when people refused to call my miscarriage a miscarriage, it felt like it took away the option.)

I noticed this tendency to avoid the label more in people who hadn't experienced their own miscarriage. Some couples who've been through pregnancy loss of their own also avoid using the word of course (and in a society that still sees the topic as taboo, and frequently discourages showing vulnerability, it's no wonder), and there were certainly those who hadn't been through a miscarriage who were still willing to use the terminology. But more often than not, I realized that if someone was unafraid to use the word in front of me, it was because they'd been there. They knew what it was called; they knew what they called theirs. What's more, they knew that refusing to label an event does nothing to change the event itself - and that embracing the label can actually be incredibly empowering.

It reminds me (as so many things do, let's be honest) of the Harry Potter books. As soon as Harry learns about his parents' death in Book 1, after ten years of being denied the truth surrounding that night, his instinct is to refer to it every time thereafter as what it really was - murder at the hands of Voldemort - even while that decision shocks everyone around him.

"You said You-Know-Who's name!" said Ron, sounding both shocked and impressed. "I'd have thought you, of all people - "

"I'm not trying to be brave or anything, saying the name," said Harry. "I just never knew you shouldn't."

Except that Harry did know - Hagrid had already told Harry that most wizards call Voldemort "You-Know-Who" or "He Who Must Not Be Named." And as the book continues, Ron has to repeatedly ask Harry to stop saying Voldemort - because Harry keeps doing it, despite Hagrid's explanations and Ron's protests. At 11 years old, Harry hardly has the words to describe why he feels the need to do this (and J.K. Rowling doesn't come out and say it either), but I think it's because to say anything else, or to avoid speaking Voldemort's name out loud, would feel dishonest and dishonoring to both his parents and his own journey of grief. He was mad that the truth about his parents' deaths had been hidden from him for so long, and now that he knew what had really happened, he wasn't going to go back to lies, omissions, or spreading misinformation. In any case, at the end of the book, Harry's choice (and mine) is vindicated when Dumbledore tells him, "Always use the proper names for things. Fear of a name increases fear of the thing itself."

As I've said in previous posts, one of the best ways to grapple with trauma is to take ownership of it - to take something that happened to you, and make it happen for you instead. The first step in this process of moving on is often getting past denial by naming and defining your experience. Using the appropriate, Google-able terms furthermore gives you access to information about what to expect (a great help in reducing fear of the unknown), and connects you with others who've gone through something similar (paramount to helping you feel less alone in your experience and provide you with a useful support system).

On the various "What to Expect When You're Expecting" miscarriage/pregnancy loss boards, and similar boards on other apps and online forums, accurate labels are in fact so common that shorthands are used instead. MC = miscarriage, MMC = missed miscarriage, CP = chemical pregnancy, EP = ectopic pregnancy, MP = molar pregnancy, BO = blighted ovum, etc. Spend any amount of time on those boards, and you quickly figure out what all those abbreviations mean.

Granted, all of those posters are on there because they want/need a space to talk about it - and there are many who experience pregnancy loss and don't want to talk about it at all - but isn't it telling that of those eager to share their experiences, none of them choose to talk about it in euphemisms? We know the deeper truth: it happened, regardless of what creative phrase you come up with to describe it - so you might as well just call it what it is. To do otherwise just compounds unnecessary confusion and misunderstanding at best - or perpetuated fear, shame, oppression, and isolation at worst.

My doctors, too, never beat around the bush - I assume from some combination of not having time or tolerance for euphemisms. My medical chart says everything: in between comments about my high-risk status due to my diabetes, there are phrases like "incomplete abortion" (the medical term for missed miscarriage) and "multigravida" (meaning that I've had more than one pregnancy). And so, every time I saw a new doctor (or one I hadn't seen in awhile, since the start of this pregnancy), the doctor would both congratulate me on my new pregnancy and acknowledge that my first had ended in loss: "We're so glad to see you back here with a healthy pregnancy!" or "That first one was just a fluke; I hope you aren't worried. Everything looks great this time!" During an appointment early in my second trimester, when a doctor was trying to find my baby's heartbeat with a Doppler wand and having a bit of difficulty, he apologized. "I know it's hard when we can't find it right away for you, after everything you've been through. But babies just hide sometimes! I'm sure I'll find their heartbeat in a minute - ah look, there it is! Strong and healthy, at 150 beats per minute."

I assumed the people who took great pains to circumnavigate the words "miscarriage" or "pregnancy loss" in my presence meant well. They likely did it because they were afraid of offending, embarrassing, or upsetting me, or because they themselves found the words offensive, embarrassing, or upsetting to say. I don't think they did it to purposefully incite shame. But when they treated those words as if they were potentially offensive or embarrassing, that's exactly what they were doing, wasn't it? Even if they didn't mean to. They were treating my miscarriage like something I should be ashamed of, something I should take offense to others knowing about and acknowledging, something that shouldn't be said out loud.

There are a whole bunch of other words like miscarriage: rape, assault, depression, suicide. They are things that our society is afraid of and uncomfortable with, and words that erroneously have connotations of blame attached. We all want to believe that there's a reason these things happen, and ways of preventing them - and the easiest way to do that is by blaming the person it most affects. (And for trauma like rape and pregnancy loss that disproportionally affect women, this impulse is all the more frequent.) But the truth is, acts of violence can happen at any time to anybody, regardless of what that person does; mental illnesses and other chronic disorders affect otherwise healthy people indiscriminately and unpredictably; and miscarriages, which occur in at least 1 in 4 pregnancies, are nearly always just a matter of horribly bad luck. These are not things that can be prevented, as much as we wish they were, and they are not things we should let anyone feel ashamed of.

If someone says they're on medication for the treatment of their depression (or anxiety or bipolar disorder or OCD or anything else), don't call it their "condition," implying that it's some nebulous, vague, unknowable disease - use the label that they and their doctors and therapists use. And if someone has publicly proclaimed that they were raped or sexually assaulted (as so many have in this era of #MeToo), don't try to find another phrase to use instead ("nonconsensual sex," "forced sex," "taken advantage of," etc.) - use the words they use: "rape" and "assault." To do anything less is to disempower the survivor who has chosen to use that word to describe their experience.

This isn't Victorian times anymore. It doesn't do anybody any good to force these topics or words into secrecy.

Of course, I'd be remiss if I didn't admit my own faults. There were times when I wanted to use the word "miscarriage" (or at least obliquely refer to mine, even without using the word), but shied away from doing so... As I've found with so many things that open us up to vulnerability, it's easier to write it in a blog post than it is to say it out loud.

My impulse to mention my first pregnancy didn't go away once I was pregnant for the second time - in fact, it was something I often wanted to do during those first few weeks. It felt weird to me to tell people I was pregnant without acknowledging what I'd been through; I always wanted to tack on the word "again": "I'm pregnant again!" I was also frequently compelled to compare my two experiences - how did my symptoms this time stack up to what I'd felt during my first pregnancy? But I did my best to curb those impulses and keep such observations mostly to myself - even while doing so felt like lies of omission and hypocrisy, perpetuating shame and stigma just as I accused others of doing.

I was worried what others might think of me if I kept bringing up my miscarriage. Would they be concerned or even disappointed in me, that even when I was getting a second chance at pregnancy I was still "complaining" about what had happened the first time? Would they think I was somehow doing a disservice to my unborn child by refusing to let them be their own person, with their own pregnancy, untainted by what I'd experienced previously? And what if someone heard me say these things who had experienced more than one miscarriage, or someone who struggled with infertility, and was still waiting for their rainbow baby, or their first positive pregnancy test to arrive - would I come across as ungrateful, would my words spark jealousy in their hearts? I knew how difficult it could be to hear about someone else's pregnancy when you were hoping and trying so hard for your own, and I didn't want to inadvertently cause anyone else that sort of pain.

I was also worried about making other people uneasy by reminding them, in the same breath as telling them my happy news, that life also brings loss sometimes. This acknowledgement did not temper my own excitement - I would argue that knowing the worst that could happen and holding that concurrently with my hopes and dreams for my new pregnancy actually made me appreciate and value my pregnancy even more. But I was worried that others might not feel the same way I did, and think me adding that "again" to the end of "I'm pregnant!" was in poor taste.

I'm trying to be better. I'm trying to care less what others think of me, and to feel less responsible for the reactions that others might have to the things I say and do. I'm trying to prioritize myself, and say the things I want to say (even if for now that means mostly just posting them on here). I want to be a role model for my future child(ren), and exemplify the traits of self-confidence, honesty, authenticity, and openness to vulnerability that I so value and admire when I see them in others.

I hope anyone reading this post will try to be better, too. And if, in the meantime, the best you can do is ask someone "How are you doing since...?" - at least that's something. In the end, I was always touched when someone took the time to contact me, and - as stated before - felt extremely grateful that so many did.

I'd much rather someone reach out clumsily than not at all.



***

*To be fair, there is some debate about the appropriateness of the term "miscarriage" - given that when you break it down into its components ("mis" and "carry") it seems to put blame on the one who was carrying the baby-to-be in their womb. Still, I think it's safe to say that if someone uses the word "miscarriage" to talk about their experience, you can assume they aren't offended by the term, and feel free to use that word yourself when talking to them about it. If you do want to avoid that particular word, "pregnancy loss" (or even just "loss") is a good substitute.

Personally, I find "pregnancy loss" to be both a more and less accurate description of my experience - it feels more accurate, in that I quite literally lost a pregnancy, and certainly didn't incorrectly carry the child I was hoping to have; it feels less accurate in that "pregnancy loss" is an umbrella term that encompasses stillbirths (losses after the 20 week mark) as well as miscarriages (losses before the 20 week mark), and I feel a bit like a fraud when lumping in my experience with others who quite literally labored and birthed a baby who may have even breathed outside the womb for a few short minutes or hours, and whom they may have had the chance to hold, however temporarily, in their arms as well as in their wombs and hearts. So while I do use both "miscarriage" and "pregnancy loss" interchangeably, I tend to default to "miscarriage" more often - just to avoid that constant internal debate with myself. (Not to mention that "pregnancy loss" just sounds clunkier in everyday conversation.)

To put an even finer point on it, I use other terms as well... I use "my miscarriage" or "my pregnancy loss" to refer generally to the weeks-long process of noting diminishing pregnancy symptoms, learning at my 8-week ultrasound that my baby had stopped growing, getting a D&C six days later, and the weeks of physical and emotional recovery that followed. But sometimes it's more convenient to reference a specific date rather than an entire process - and when that's the case (as it often was when we were trying to conceive again), I chose September 13 and called it "my D&C" (e.g. "this is my Nth menstrual cycle since my D&C"). More often, I think of the entire pregnancy, not just the end of it (and sometimes not the end of it at all), and I refer to it as "my first pregnancy" or "my last pregnancy" ("last" meaning previous, not final). Even when I was not yet pregnant again, I always used one of those qualifiers; trying to conceive requires a certain optimism and forwardness of perspective that assumes another pregnancy is just around the corner, if not already begun.

I don't care which of those terms you use with me - miscarriage, loss, pregnancy loss, your first pregnancy, etc. All of them are true, better than the verbose "that painful, difficult thing that happened to you last fall, which I read about on your blog," and refreshing to hear.

And if you're not sure what someone else wants their experience to be called - ASK THEM! I know it can be awkward and nerve-wracking, but if you want others to feel safe enough to be emotionally vulnerable around you and tell you how they're feeling, you might just have to be emotionally vulnerable around them, too. :)

Thursday, September 26, 2019

For When Times Are Tough

I've talked in previous posts (Missed Miscarriage, Yellow Nursery Stripes, April 19, From August to August) about the healing process I went through after my miscarriage - facing the grief and finding the strength to try it all again in pursuit of my dreams.

One thing I did was spend a lot of time finding and compiling facts and quotations I found personally helpful. I started with encouraging statistics and uplifting sentiments that were miscarriage-specific, but as I felt emotionally stronger, my document quickly evolved into one filled with more generic advice - something I thought I might be able to refer to again, for any number of losses (deaths, relationships, career choices, self-doubt, etc.), whenever the inevitable next one happened in my life.

Finding these quotations and organizing them into a love letter of sorts/a how-to guide for myself was very therapeutic for me (and admittedly a very "Ravenclaw" thing to do, so I realize it's not everyone's cup of tea...) It was also likely the process of creating the list, more than the actual content, which helped me most, since it necessitated spending time self-reflecting and prioritizing my mental health. I don't know if I actually will refer to this list again in the future; I might compile an entirely new list instead.

Still, I thought I would share some of the quotations I found (and the structure I organized them into), in case this might help anyone else, too. When I find it hard to accept my own thoughts or truly believe my own words, reading the words that others have written can be wonderfully affirming and invaluable.

An abridged version of the document I created is below. (And yes, the full document I wrote - and am still adding to, whenever I find more quotes that speak to me - really is even longer than this!) :)

***

You're allowed to feel the way you feel. You are allowed to grieve for things you've lost. First, you need to give yourself that time.

Then, when the grief is no longer all-consuming, read this letter to remind yourself that you are also allowed to romanticize, reframe, and transform your pain. You do not have to keep living in it.

Some of these sentiments contradict each others; still others are at least occasionally untrue. They may be things you want to believe, but have trouble actually believing. On days when you are determined to get in the way of your own happiness, that may seem like enough reason to reject them. But remember: something does not have to be an absolute truth to be beneficial.

"You're going to live your life based on delusions (and you are, because we all do)... Why not at least select a delusion that is helpful?" (Elizabeth Gilbert - Big Magic: Creative Living Beyond Fear)

Think of this not as a list of truths, but as a list of useful delusions. And if that is not enough - if at any time your grief returns or you don't have it in you to forge continuously ahead - you are allowed to take a step back and grieve all over again. Grief is not linear. The words below will not always give you comfort. But in those moments when you're healed enough to hear them, they are here for you.

"The time to repair the roof is when the sun is shining." (John F. Kennedy)

This letter is your roof, and you have prepared it so it will be there for you when next it rains. Use it. May these words inspire you, and may its compilation remind you of your foresight and strength. You have outlived grief in the past, and you will outlive it again.

*

Dear Andrea,

Times are tough right now - so tough that you may want nothing more than to deny it or move quickly past it. But first you need to make sure you've allowed yourself to truly feel your grief. Name it. Analyze it. Confront it. Write about it.
  • "Numbing the pain for awhile will make it worse when you finally feel it." (J.K. Rowling - Harry Potter and the Goblet of Fire)
  • "Of all the things in the world, suffering is the most real. You can never ignore it or doubt it." (Yuval Noah Harari - 21 Lessons for the 21st Century)
  • "Research has found that the act of not discussing a traumatic event or confiding it to another person can be more damaging than the actual event... Writing about traumatic experience can produce measurable changes in physical and mental health." (Brene Brown - Daring Greatly)
  • "To survive something we first need to know what it is we're surviving." (Miriam Toews - All My Puny Sorrows)
To be human is to grieve, and for better or worse, you are a part of the web of humanity.
  • "Every human requires food and water to survive and every human has a heart that bleeds, loves, and grieves." (Suzy Kassem - Rise Up and Salute the Sun)
  • "Life isn't pretty / We all get a little wrecked sometimes." (The Veronicas - On Your Side)
  • "You are allowed to feel messed up and inside out. It doesn't mean you're defective - it just means you're human." (David Mitchell - Cloud Atlas)
  • "Life is a series of losses... We're all terminal." (Kate Bowler - Everything Happens for a Reason: And Other Lies I've Loved)
  • "There's always gonna be another mountain / I'm always gonna wanna make it move / Always gonna be an uphill battle / Sometimes I'm gonna have to lose" (Miley Cyrus - The Climb)
  • "It if don't hurt now, just wait, just wait awhile / Ain't in fun / Living in the real world" (Paramore - Ain't It Fun)
Life is, at times, inexplicably and inescapably awful. The bad and good in life are permanently tied up in each other. Uncleavable.
  • "I've made some friends, and I've lost some too." (Andrew McMahon - Cecilia and the Satellites)
  • "You know time will give and time will take." (Phillip Phillips - Raging Fire)
  • "I can't reconcile the way that the world is jolted by events that are wonderful and terrible, the gorgeous and the tragic. Except that I am beginning to believe that these opportunities do not cancel each other out. Life is so beautiful. Life is so hard." (Kate Bowler - Everything Happens for a Reason: And Other Lies I've Loved)
You did nothing to deserve this pain. You did nothing wrong. In fact - you're doing everything right. You're hurt right now because in trying to experience all the good that life has to offer, you also stumbled upon the bad. You lost because you were brave enough to try to win.
  • "Now we're falling through the ice / We made our bed and rolled the dice / Well every gamble has a price." (Banners - Empires on Fire)
  • "Everybody tries to put some love on the line / And everybody feels a broken heart sometimes." (Teddy Geiger - These Walls)
  • "The sorrow we feel when we lose a loved one is the price we pay to have had them in our lives." (Rob Liano)
  • "What are you passionate enough about that you can endure the most disagreeable aspects of it?" (Elizabeth Gilbert - Big Magic: Creative Living Beyond Fear)
When you love someone or something, you make yourself vulnerable to loss.
  • "The course of true love never did run smooth." (William Shakespeare - A Midsummer Night's Dream)
  • "Love is uncertain. It is incredibly risky. And loving someone leaves us emotionally exposed." (Brene Brown - Daring Greatly)
  • "Where there is desire, there is gonna be a flame / Where there is a flame, someone's bound to get burned." (Pink - Try)
  • "I find it bittersweet / 'Cause you gave me something to lose / If you love someone and you're not afraid to lose 'em / You'll probably never love someone like I do." (Lukas Graham - Love Someone)
  • "He who loves 50 people has 50 woes; he who loves no one has no woes." (Buddha)
  • "Here's the truth: Who is spared love is spared grief." (David Mitchell - Bone Clocks)
But that is no reason not to love, or live.
  • "Vulnerability is the core, the heart, the center of meaningful human experiences... To foreclose on our emotional life out of a fear that the costs will be too high is to walk away from the very thing that gives purpose and meaning to living... Living without connections - without knowing love and belonging - is not victory." (Brene Brown - Daring Greatly)
  • "When we were children, we used to think that when we were grown up we would no longer be vulnerable. But to grow up is to accept vulnerability. To be alive is to be vulnerable." (Madeleine L'Engle)
  • "Love doesn't discriminate / Between the sinners and the saints / It takes and it takes and it takes / And we keep loving anyway... Death doesn't discriminate / Between the sinners and the saints / It takes and it takes and it takes / And we keep living anyway" (Hamilton Soundtrack -Wait for It)
  • "Hope that you fall in love / And it hurts so bad / The only way you can know / You gave it all you had." (One Republic - I Lived)
  • "If this love is pain, well darling, let's hurt tonight." (One Republic - Let's Hurt Tonight)
If we try to avoid the bad, we will fail to experience any of the good. There is nothing to do but lean in and embrace it all.
  • "The world is an ugly place. We must live in it." (Madeline Miller - Circe)
  • "If you hide under the covers / You might never see the light of day" (Mary Poppins Returns - Trip a Little Light Fantastic)
  • "Numbing vulnerability doesn't just deaden the pain of our difficult experiences; numbing vulnerability also dulls our experiences of love, joy, belonging, creativity, and empathy. We can't selectively numb emotion. Numb the dark and you numb the light." (Brene Brown - Daring Greatly)
  • "Action may not always bring happiness, but there is no happiness without action." (Benjamin Disraeli)
  • "You are here to risk your heart. You are here to be swallowed up. And when it happens that you are broken, or betrayed, or left, or hurt, or death brushes near, let yourself sit by an apple tree and listen to the apples falling all around you in heaps, wasting their sweetness. Tell yourself you tasted as many as you could." (Louise Erdrich - The Painted Drum)
Practice fearlessness - even when you're afraid.
  • "Even when I'm scared I have to try to fly / Sometimes I fall / But I've seen it done before / I gotta step outside these walls" (Teddy Geiger - These Walls)
  • "If the highest aim of a captain were to preserve his ship, he would keep it in port forever." (Thomas Aquinas)
  • "You have plenty of courage. All you need is confidence in yourself. There is no living thing that is not afraid when it faces danger. The true courage is in facing danger when you are afraid." (L. Frank Baum - The Wonderful Wizard of Oz)
  • "I wanted you to see what real courage is. It's when you're licked before you begin, but you begin anyway and see it through no matter what." (Harper Lee - To Kill a Mockingbird)
  • "Living a life that is driven more strongly by curiosity than by fear... You have to be willing to take risks if you want to live a creative existence." (Elizabeth Gilbert - Big Magic: Creative Living Beyond Fear)
  • "May your choices reflect your hopes, not your fears." (Nelson Mandela)
We can't choose what happens to us when we try. But we can choose to try anyway. And the act of making that choice both forges and proves our inner strength.
  • "There are only two mistakes one can make: not going all the way, and not starting." (Buddha)
  • "I am not what has happened to me. I am what I choose to become." (Carl Jung)
  • "Vulnerability is not weakness, and the uncertainty, risk, and emotional exposure we face every day are not optional. Our only choice is a question of engagement. Our willingness to own and engage with our vulnerability determines the depth of our courage and the clarity of our purpose." (Brene Brown - Daring Greatly)
  • "It was the difference between being dragged into the area to face a battle to the death and walking into the arena with your head held high. Some people, perhaps, would say that there was little to choose between the two ways, but... there was all the difference in the world." (J.K. Rowling - Harry Potter and the Half-Blood Prince)
  • "The credit belongs to the man who is actually in the arena... who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly." (Theodore Roosevelt)
Picking yourself up and trying again is a choice you may have to make over and over again. But you can, and you will.
  • "Just because it burns doesn't mean you're gonna die / You gotta get up and try, try, try" (Pink - Try)
  • "Being defeated is often a temporary condition. Giving up is what makes it permanent." (Marilyn vos Savant)
  • "You may have to fight a battle more than once to win it." (Margaret Thatcher)
  • "This is how things go. You fix them, and they go awry, and then you fix them again." (Madeline Miller - Circe)
  • "It was important to fight, and fight again, and keep fighting, for only then could evil be kept at bay, though never quite eradicated." (J.K. Rowling - Harry Potter and the Half-Blood Prince)
  • "Our greatest glory is not in never failing, but in rising every time we fall." (Confucius)
  • "I'll rise up / High like the waves / I'll rise up / In spite of the ache / I'll rise up / And I'll do it a thousand times again." (Andra Day - Rise Up)
You will glean wisdom from this pain. It will grow you and deepen you.
  • "Experience is the only thing that brings knowledge and the longer you are on earth the more experiences you are sure to get." (L. Frank Baum - The Wonderful Wizard of Oz)
  • "Biology gives you a brain. Life turns it into a mind." (Jeffrey Eugenides - Middlesex)
  • "It matters not what someone is born, but what they grow to be." (J.K. Rowling - Harry Potter and the Goblet of Fire)
  • "People who only have good experiences aren't very interesting. They may be content, and happy after a fashion, but they aren't very deep." (Peter Cameron - Someday This Pain Will Be Useful to You)
  • "The goal is not getting comfortable, but normalizing discomfort. We need to cultivate the courage to be uncomfortable and to teach people around us how to accept discomfort as a part of growth." (Brene Brown - Daring Greatly)
  • "Don't give in / Don't you dare quit so easy / There is a lot we can learn from this loss" (Snow Patrol - Don't Give In)
  • "It's times like these you learn to live again / It's times like these you give and give again / It's times like these / Time and time again" (Foo Fighters - Times Like These)
Suffering brings enlightenment and empathy.
  • "The wound is the place where the Light enters you." (Rumi)
  • "I had to go through hell to prove I'm not insane / Had to meet the devil just to know his name." (Ella Henderson - Ghost)
  • "Vulnerability is the birthplace of love, belonging, joy, courage, and creativity. It is the source of hope, empathy, accountability, and authenticity. If we want greater clarity of our purpose or deeper or more meaningful spiritual lives, vulnerability is the path. (Brene Brown - Daring Greatly)
  • "There is no shame in what you are feeling. On the contrary, the fact that you can feel pain like this is your greatest strength." (J.K. Rowling - Harry Potter and the Order of the Phoenix)
  • "My own suffering began to feel like it had revealed to me the suffering of others, a world of those who, like me, are stumbling in the debris of dreams they thought they were entitled to and plans they didn't realize they had made." (Kate Bowler - Everything Happens For a Reason: And Other Lies I've Loved)
  • "The pain sculpts us into someone who understands more deeply, hurts more often, appreciates more quickly, cries more easily, hopes more desperately, and loves more openly." (Unknown)
  • "In order to act morally...you need to develop a deep appreciation of suffering... And if you want to know the truth of the universe, about the meaning of life, and about your own identity, the best place to start is by observing suffering and exploring what it is." (Yuval Noah Harari - 21 Lessons for the 21st Century)
  • "Compassion is not a relationship between the healer and the wounded. It's a relationship between equals. Only when we know our own darkness well can we be present with the darkness of others." (Pema Chodron)
You are a block of marble, and pain is the chisel gradually shaping you into the masterpiece that you are. It's good that difficult times are inevitable - because they are also useful.
  • "Under this pressure, under this weight / We are diamonds taking shape" (Coldplay - Adventure of a Lifetime)
  • "Grief does not change you. It reveals you." (John Green - The Fault in Our Stars)
  • "Even if I could [erase your scars], I wouldn't. Scars can come in handy. I have one myself above my left knee that is a perfect map of the London Underground." (J.K. Rowling - Harry Potter and the Sorcerer's Stone)
  • "The scars themselves I offered to wipe away. He shook his head. 'How would I know myself?' They suited him. Whoever saw him must salute and say: There is a man who has seen the world. There is a captain with stories to tell." (Madeline Miller - Circe)
  • "I am brave, I am bruised / I am who I'm meant to be / This is me." (Keala Settle, The Greatest Showman Soundtrack - This is Me)
Life is built from pain; so use your pain to build the life you desire. Treat this experience as nourishment for your soul and the spark that can light your creative projects.
  • "The winter's cold / But the snow still lightly settles on the trees / And a mess is still a moment I can seize" (Gabe Dixon Band - All Will Be Well)
  • "You're going to go through tough times - that's life. But I say, 'Nothing happens to you, it happens for you.' See the positive in negative events." (Joel Osteen)
  • "I cannot bear this world a moment longer... Then child, make another." (Madeline Miller - Circe)
  • "The opposite of war isn't peace... It's creation!" (Rent Soundtrack - La Vie Boheme)
  • "Grief needs an outlet. Creativity offers one." (Hope Edelman)
  • "Artists crave experiences because that's how they make art." (Whitney Scharer - The Age of Light)
  • "Pick up a pen, start writing / I wanna talk about what I have learned / The hard-won wisdom I have earned." (Hamilton Soundtrack - One Last Time)
There is a time in every compelling narrative when things get difficult. Without conflict to overcome, there is no story. It is not easy - but it is worth it.
  • "There was only one way to the other side, and that was through the pain." (Vanessa Diffenbaugh - The Language of Flowers)
  • "The harder the struggle, the more glorious the triumph." (Unknown)
  • "Such narrative arcs make good movies but shitty existences." (David Mitchell - Bone Clocks)
  • "I guess the bad can get better / Gotta be wrong before it's right / But still the growing pains, growing pains are keeping me up at night" (Alessia Cara - Growing Pains)
  • "You have set yourselves a difficult task, but you will succeed if you persevere; and you will find a joy in overcoming obstacles. Remember, no effort that we make to attain something beautiful is ever lost." (Helen Keller)
Challenging times are opportunities to remind yourself what you're made of, and chances to grow further evidence of your tenacity and success.
  • "When we meet real tragedy in life, we can react in two ways - either by losing hope and falling into self-destructive habits, or by using the challenge to find our inner strength." (Dalai Lama)
  • "Grief and resilience live together." (Michelle Obama - Becoming)
  • "What does not destroy me makes me stronger." (Friedrich Nietzsche)
  • "Do not confuse my bad days as a sign of weakness. Those are the days I am actually fighting my hardest." (Unknown)
  • "Experience gives us the advantage of knowing that we can survive the exposure and uncertainty, and that it's worth the risk." (Brene Brown - Daring Greatly)
  • "You can take everything I have / You can take everything I am / Like I'm made of glass, like I'm made of paper / Go on and try to tear me down / I will keep rising from the ground / Like a skyscraper" (Demi Lovato - Skyscraper)
In the future, you will cherish the memories of this experience, and draw on them for comfort and strength.
  • "Give it all or give it up / I won't settle for enough / It's the highs and it's the lows we remember" (Ocean Park Standoff - Good News)
  • "There will be a sea of tears / But sooner or later the sea will dry up / And you'll learn to embrace the wet sand revealed." (Sanhita Baruah)
  • "One day in retrospect, the years of struggle will strike you as the most beautiful." (Sigmund Freud)
  • "Someday you're gonna look back on this moment of your life as such a sweet time of grieving. You'll see that you were in mourning and your heart was broken, but your life was changing." (Elizabeth Gilbert)
Your narrative is your own narrative, and it will follow its own timeline.
  • "There is purpose in your season of waiting." (Megan Smalley)
  • "Time is a force and we must allow it to do its work, must respect its power." (Miriam Toews - All My Puny Sorrows)
  • "Anxiety happens when you think you have to figure out everything all at once. Breathe. You're strong. You got this. Take it day by day." (Karen Salmansohn)
  • "If we walk far enough, we shall sometime come to someplace." (L. Frank Baum - The Wonderful Wizard of Oz)
  • "Don't rush through the experiences and circumstances that have the most capacity to transform you." (Rob Bell)
Don't worry about what future bad things might happen.
  • "Contemplating the task ahead would not make it easier." (J.K. Rowling - Harry Potter and the Deathly Hallows)
  • "I don't think being frightened will help." (Madeline Miller - Circe)
  • "Worry does not take away tomorrow's troubles. It takes away today's peace." (Randy Armstrong)
  • "No good sittin' worryin' about it. What's comin' will come, an' we'll meet it when it does." (J.K. Rowling - Harry Potter and the Goblet of Fire)
Don't wallow in what would've-could've-should've been, either.
  • "Nostalgia is a dangerous form of comparison." (Brene Brown - Daring Greatly)
  • "You're holding on to what you never had" (Hailee Steinfeld - Let Go)
  • "Don't fall in love with the way things were / It'll fuck up your mind" (Snow Patrol - Don't Give In)
  • "Leave the past behind you. If you don't leave it there, it clutters everything up and you just keep tripping over it." (Laini Taylor - Muse of Nightmares)
  • "May your past be the sound / Of your feet upon the ground / And carry on" (Fun. - Carry On)
Focus instead on the vast potential of your present and future - the things that are still changeable, the successes and joys you've yet to see. Allow yourself to be happy and optimistic. Allow yourself to hope and dream and want things.
  • "Yesterday is not ours to recover, but tomorrow is ours to win or lose." (Lyndon B. Johnson)
  • "It is as wrong to deny the possible as it is to deny the problem." (Dr. Dennis Saleebey)
  • "We must have the stubbornness to accept our gladness in the ruthless furnace of this world." (Jack Gilbert)
  • "You'll never find a rainbow if you're looking down." (Charlie Chaplin)
  • "We are all in the gutter, but some of us are looking at the stars." (Oscar Wilde)
  • "Happiness can be found, even in the darkest of times, if one only remembers to turn on the light." (J.K. Rowling - Harry Potter and the Prisoner of Azkaban)
  • "The world unwraps itself to you, again and again as soon as you are ready to see it anew." (Gregory Maguire - Wicked)
Allow yourself to try again - to throw yourself back into the fray, to make new plans and follow through on them.
  • "It does not do to dwell on dreams and forget to live." (J.K. Rowling - Harry Potter and the Sorcerer's Stone)
  • "Life won't just happen to you. You have to happen to it." (Laini Taylor - Strange the Dreamer)
  • "Hope is a combination of setting goals, having the tenacity and perseverance to pursue them, and believing in our own abilities." (Brene Brown - Daring Greatly)
  • "Wishes don't just come true. They're only the target you paint around what you want. You still have to hit the bull's-eye yourself." (Laini Taylor - Muse of Nightmares)
Life doles out enough grief without you willfully adding more as a form of self-punishment. You don't have to wallow in it and invite it to prolong its stay in your heart.
  • "I keep dragging around what's bringing me down / If I just let go, I'd be set free" (Linkin Park/Kiiara - Heavy)
  • "All the broken hearts in the world still beat / Let's not make it harder than it has to be" (Ingrid Michaelson - Girls Chase Boys)
  • "All my life had been murk and depths, but I was not a part of that dark water. I was a creature within it." (Madeline Miller - Circe)
  • "I'd been stoking the most negative parts of myself, caught up in the notion that everything was unfair and then assiduously, like a Harvard-trained lawyer, collecting evidence to feed that hypothesis. I now tried out a new hypothesis: It was possible that I was more in charge of my happiness than I was allowing myself to be." (Michelle Obama - Becoming)
  • "Our creativity grows like sidewalk weeds out of the cracks between our pathologies - not from the pathologies themselves... I refuse to seek out suffering in the name of artistic authenticity." (Elizabeth Gilbert - Big Magic: Creative Living Beyond Fear)
Don't let hopelessness catch you in its spiral, telling you that where you are now is where you will remain forever. This is a self-fulling prophecy, a trap - and to believe such absolutes is a form of arrogance. You do not know what is to come.
  • "Please keep in mind that whatever you're going through, this challenging time in your life is merely IN your life. It is not your whole life. So be sure to keep this slice of life in perspective and don't let it overwhelm you. Remember: nothing is everything. The part is not greater than the whole." (Karen Salmansohn)
  • "Tone down the prophecies of doom and switch from panic mode to bewilderment. Panic is a form of hubris. It comes from the smug feeling that one knows exactly where the world is heading: down. Bewilderment is more humble and therefore more clear-sighted... Try telling yourself, 'Truth is, I just don't understand what's going on.'" (Yuval Noah Harari - 21 Lessons for the 21st Century)
  • "Doubt kills more dreams than failure ever will." (Suzy Kassem)
  • "Just because something isn't happening for you right now doesn't mean that it will never happen." (Unknown)
  • "In this sad world of ours sorrow comes to all and it often comes with bitter agony. You may believe that you will never feel better. But this is not true. You are sure to be happy again." (Abraham Lincoln)
It is often easier to fall for that trap of depression than it is to remain hopeful - but just because something is easy does not mean it is the best course.
  • "There will be a time when we must choose between what is easy and what is right."
     (J.K. Rowling - Harry Potter and the Goblet of Fire)
  • "He had been broken and reassembled as a shell, only then to do the bravest thing of all: He had kept on living, though there are easier paths to take." (Laini Taylor - Strange the Dreamer)
  • "Dying is easy - living is harder" (Hamilton Soundtrack - Right Hand Man)
  • "We must try not to sink beneath our anguish, but battle on." (J.K. Rowling - Harry Potter and the Half-Blood Prince)
  • "Don't squander joy. We can't prepare for tragedy and loss. When we turn every opportunity to feel joy into a test drive for despair, we actually diminish our resilience. Every time we allow ourselves to lean into joy and give in to those moments, we build resilience and we cultivate hope." (Brene Brown - Daring Greatly)
  • "Healing takes courage, and we all have courage, even if we have to dig a little to find it." (Tori Amos)
Faith is fuel, keeping you moving through long stretches of desert. Belief in the future, in a light you cannot see, is not foolishness, but bravery.
  • "You don't have to see the whole staircase. Just take the first step." (Martin Luther King, Jr.)
  • "You need a leap of faith to leave your old life behind. True metamorphosis doesn't come with flowcharts." (David Mitchell - Bone Clocks)
  • "That's what faith is, isn't it? Following the music when we don't hear it." (Francisco X. Stork - Marcelo in the Real World)
Believe in yourself. Forgive yourself. Be kind to yourself.
  • "Never apologize, never explain it away, never be ashamed of it. You did your best with what you knew, and you worked with what you had, in the time that you were given." (Elizabeth Gilbert - Big Magic: Creative Living Beyond Fear)
  • "Cultivate the courage to be imperfect and self-compassionate. Perfectionism is not the path that leads us to our gifts and to our sense of purpose; it is a hazardous detour... Our worthiness, that core belief that we are enough, comes only when we own our stories (even the messy ones)." (Brene Brown - Daring Greatly)
  • "Even when it's not pretty or perfect. Even when it's more real than you want it to be. Your story is what you have, what you will always have. It is something to own." (Michelle Obama - Becoming)
  • "We have to be willing to give ourselves a break and appreciate the beauty of our cracks and imperfections. To be kinder and gentler with ourselves and each other. To talk to ourselves the same way we'd talk to someone we care about." (Brene Brown - Daring Greatly)
  • "You, yourself, as much as anybody in the entire universe, deserve your love and affection." (Buddha)
There are things that are going to be outside your control. Understanding that is not an admission of failure, but an important step toward acceptance.
  • "Control is a drug, and we are all hooked, whether or not we truly believe that we can master the future with our words and attitudes. The entire motivational-speaking industry rests on the assumption that you can have what you want, you can be what you want... [and that] there is a hidden logic to this seeming chaos... [But] nothing human or divine will map out this life, this life that has been more painful than I could have imagined. More beautiful than I could have imagined." (Kate Bowler - Everything Happens for a Reason: And Other Lies I've Loved)
  • "Someday it might make sense to you - why you needed to go through this botched-up mess in order to land in a better place. Or maybe it will never make sense. So be it. Move on anyway." (Elizabeth Gilbert - Big Magic: Creative Living Beyond Fear)
  • "'It is not fair' and 'It cannot be' are two different things." (Madeline Miller - Circe)
  • "Fairness is one of the most compelling claims of the American Dream, a vision of success propelled by hard work, determination, and maybe the occasional pair of bootstraps... In a world of fair, nothing clung to can ever slip away... Give up that little piece of the American Dream that says 'You are limitless'. Everything is not possible." (Kate Bowler - Everything Happens for a Reason: And Other Lies I've Loved)
But just because some things are uncontrollable does not mean everything is. Control what you can. Even when you are swimming in uncertainty, there is always something you can do. You can try to enjoy today.
  • "We are never so wise as when we live in this moment." (Paul Kalanithi - When Breath Becomes Air)
  • "Do not save this for tomorrow / Embrace the past and you can live for now / This is the new year / A new beginning" (A Great Big World - This is the New Year)
  • "There's only now / There's only here/ Give in to love / Or live in fear / No other path / No other way / No day but today" (Rent Soundtrack - Another Day)
Be grateful for where you are right now. If your lungs are still breathing, your heart still beating, you have at least two things to marvel at.
  • "A rainy day is better than no day." (Rachel Simon - The Story of Beautiful Girl)
  • "Even if I'm dying, until I actually die, I am still living." (Paul Kalanithi - When Breath Becomes Air)
  • "Live unburdened. Live free. Live without forevers that don't always come... The water is rising and levees may break and it will sweep us all away. But until then, I am here." (Kate Bowler - Everything Happens for a Reason: And Other Lies I've Loved)
  • "Look around, look around at how lucky we are to be alive right now / Look at where you are / Look at where you started / The fact that you're alive is a miracle / Just stay alive, that would be enough" (Hamilton Soundtrack - That Would Be Enough)
  • "Aging is a fucking privilege." (Kate Bowler - Everything Happens for a Reason: And Other Lies I've Loved)
  • "It doesn't mean that it does not hurt. It doesn't mean that we are not frightened. Only that: we are here. This is what it means to swim in the tide, to walk the earth and feel it touch your feet. This is what it means to be alive." (Madeline Miller - Circe)
Remember: if the bad and good are permanently tied up in each other, that means good times are also inevitable. Good times are coming. You will get through this. This too shall pass.
  • "If life didn't change, it wouldn't be life, it'd be a photograph." (David Mitchell - Bone Clocks)
  • "Even the darkest night will end and the sun will rise." (Victor Hugo)
  • "It's been a long cold lonely winter / It feels like years since it's been here... Here comes the sun / Here comes the sun, and I say / It's alright" (The Beatles - Here Comes the Sun)
  • "All will be well / You can ask me how but only time will tell" (Gabe Dixon Band - All Will Be Well)
  • "This feeling will pass. This workload will pass. These people will pass. This moment will pass. This fatigue will pass." (Lin-Manuel Miranda - Gmorning Gnight)
  • "It's funny how some distance makes everything seem small / And the fears that once controlled me can't get to me at all" (Frozen Soundtrack - Let it Go)
  • "Pain will come with time, but time will heal the pain." (Anthony Liccione)
Letting go of the comfort of grieving can be difficult. But you are capable of accomplishing this final hurdle in moving on. Just because something is gone does not mean it will be forgotten.
  • "I wanna let go but there's comfort in the panic" (Linkin Park/Kiiara - Heavy)
  • "The brain is built to forget things as we continue to live; memories are meant to fade and disintegrate and sharp edges become blunt; the pain of letting go of grief is just as painful or even more painful than the grief itself. It means goodbye." (Miriam Toews - All My Puny Sorrows)
  • "This is what I know about loss: It doesn't get better. You just get (somewhat) used to it." (Jennifer Niven - Holding Up the Universe)
  • "You think the dead we loved ever truly leave us? You think that we don't recall them more clearly in times of great trouble?" (J.K. Rowling - Harry Potter and the Prisoner of Azkaban)
  • "Nothing's really left or loss without a trace / Nothing's gone forever - only out of place... Maybe all you're missing lives inside of you" (Mary Poppins Returns - Where Lost Things Go)
I love you and I believe in you.

Love, Andrea

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."