Thursday, June 21, 2007

Itchy Bitchy Wife

After working myself into the finest of lathers over the loss of my vacation, DH called and said that he managed to work it out so that he can still go camping. Whoo-hoo! He also says that the reason he didn't put the notice in writing ahead of time for his vacation is that his office has no official system for doing so.

I was about to say "What? How could a company not have a way to plan ahead like that?" But then I remembered that this is the video game industry we were talking about, where many employees likely never take vacation at all. It is entirely likely that there is no system in place to log requests for them.

Now I feel bad for being so bitchy on the phone with poor DH about this. He's such a sweet guy, and it's not as though he actually wants to have his deadline moved so it screws with our camping. Time to go make nice ...

Monday, June 18, 2007

Sobby-Story Life

This post was going to be about how lovely my weekend was , filled with planting flowers in the yard, leisurely breakfasts on the patio, playing tag with Big A, and hanging out with our nieces. (I did up a nice Father's day meal and gifty thing for DH, if I do say so myself.) And last night while I was doing chores after the kids fell asleep I felt really content. It was part afterglow from the weekend, part anticipation of the next few months. In my mind I saw many afternoons where the kids would be splashing in the kiddie pool and we would all be relaxing together. And most of all, I saw vacations. Summery, sparkly holidays!

DH really wanted to visit our parents (who all live in the same town) this summer because Big A is finally old enough for us to fly without tranq doses all around and Little A is young enough that she won't get incredibly antsy on airplanes yet. But while the timing is right, the price of four tickets to East Bumblefuck NY most certainly is not. In the last few years high fuel costs and airline industry consolidation have doubled the cost of going there. The price for tickets and car rental needed to visit the family is now comparable to an entire month's home-owner's insurance, local tax, and mortgage payments for us in the San Francisco Bay Area. Yikes.

Even if we had that kind of extra money, I'm from a place that Garfield author Jim Davis reportedly claimed was the source of his strip's "inspiration." When the author of a comic as lame as Garfield recognizes your home town is even lower on the totem pole of shame than he is, safe to say that it's not worth taking out a loan out to visit.

So rather than taking a full week off and flying somewhere, we finally decided that we'd go on a couple long-weekend camping trips this summer instead. Even though we had to buy a bigger tent to accommodate the growing family and also get a car-top carrier to haul all our stuff, it was still multiple-times cheaper to do that than fly someplace. And I actually like camping a lot. I love cooking on the cute little stove and snuggling down into my sleeping bag in the cozy little tent with my family surrounding me at night. Also, flashlights! I have a new LED one I can't wait to play with ...

But then DH calls me from work today saying a project deadline might be moved back so that it falls in our July camping trip. Oh, and that holiday known as July 4th? They have to work that day, too. The consolation is that they'll get two comp days off at the end of July. But this doesn't seem like much consolation, given that I can't just up and transfer my campsite reservations to the new days off.

DH works in the video game industry, and anything I can say about their work practices and long hours has already been said more famously before by others. But I am so tired of this sort of thing interfering with our lives. First, we aren't even going away for a whole week, just a few days. Why is it that we cannot even take a four-day weekend without work drama? Second, why is it that DH did not get the trips cleared ahead of time with his boss PRIOR to the schedule change? I told him the dates back in April when I booked the campsites and asked that he get it cleared with a supervisor so that if anything like this occurred (because it ALWAYS occurs) he could prove that it was a long-booked trip he'd already cleared with his boss.

I know this last part didn't happen at all, since when DH called me today it was "verify" the trip dates, meaning that they weren't even written down in his day planner.

Grrrr. I guess my big camping trip this year might involve setting up the tent in the back yard.

Thursday, June 14, 2007

Nope. Never Had that Happen.

Big A: Mommy?

Wabi: Yes?

Big A: Did you ever have an accident and drop the baby in the toilet and have her go down the drain with the water?


Little A (in the background): Gah!

Wabi: Uh, no. Never had that happen ...

Monday, June 11, 2007

Unhappy Unbirthday

This week is the anniversary of my lost baby's estimated due date. Happy unbirthday, baby. Unhappy, bittersweet day for me. In a parallel universe, I'm in the middle of posting birthday photos of you up on my blog ...

For the longest time I spent a rueful portion of my time in that aforementioned parallel universe, a place where my angel baby did not have a fatal genetic problem. That Wabi was sashaying around town with an unscarred body and an unbattered mind, a rosy-cheeked little bub strapped into her Bjorn as she walked to the park with Big A to meet friends, eat tasty, organic snacks, and enjoy witty reparte about whatever idiotic thing was cresting the news cycle that day. Coincidentally, that Wabi appeared particularly unwrinkled and svelte, and had a better job than I do. And I would call her a bitch out of envy, but of course she was too nice to wear the mantle of bitch ... oh, and you should have seen that Wabi's house. It was fantastic.

Marking time in that fabled parallel universe was sweet at first. So much better than the real world. But the problem was I could never find any balance between there and here. After awhile focusing so much on what might have been was more destructive than good. It's like drinking: One drink loosens you up to enjoy the party, but fifteen will break up the party. I could never stop at one. There was no moderation in my grief, only obsession and bottomless fury and sadness. I could not mourn within certain proscribed hours of the day, leaving blocks of time for quality time with family, work projects, and a little yard work. Everything in life was groaning at the seams, ready to fall apart. Yet all I could do was yearn that it was different. Yearning of course does not actually make anything real different, unfortunate as that is.

The biggest gift Little A gave me was the ability to let go of that phantom universe and to live resolutely in the present. There is a moment in the movie "Waitress" where the main character looks at her baby and says "OH MY GOD," and suddenly her life snaps into focus, and all sorts of good things that seemed impossible before that moment are suddenly within reach. That would have seemed like a ridiculous writing conceit to me before I had Little A. But afterwards, I just sat in the theater squeezing DH's hand and nodding. Yeah, that's how it was. Thank God. That's how it was.

So, I am here now. Not holding a phantom baby in my mind, but jiggling a real one on my knee. I am here with the poop accidents and knock-knock jokes and the prodigious amounts of drool, not to mention the ever-growing spider colony in the garage. I am here for quiet snuggles with the kids on the couch. I am here for those other not-so-endearing times when the vein in my forehead actually bursts through the skin and pulses like a garden hose because something has irritated me to the brink of death. Day in and day out, sometimes overjoyed and sometimes not, I am caught in the flowing river of real life again. Here.

And yet, as right as this feels, on this particular day I cannot help but think of my little angel baby again and yearn for her in the old, not-so-healthy way. She deserved to be more than a lesson in carpe diem for her family. She brought that too and we'll take it, but c'mon. She deserved the chance for a life that a random genetic mutation robbed her from ever being able to have. There is such sadness in that. This is the part of the grief that will never go away, no matter how far away I travel from parallel-universe land. The feelings I have about my own hurts have changed. Anger and what-ifs can and do fade to something else. But the things that trisomy 18 took from my baby remain unchanged. And I will always feel those losses for my baby, on her behalf.

Wednesday, June 6, 2007

Attack of the Zombie Yaks

This is my first week back at work since December. I went back too soon after Big A was born and felt all sorts of pissy and stressed. But this time I was actually sort of ready, looking forward to it, even. I felt sad dropping off Little A at daycare, but unlike the first time I ever left Big A at a babysitter, I managed not to cry hysterically at this milestone. I think it helped that Big A was insanely thrilled that Little A is now old enough to go to the babysitter with her. We laid Little A down on the floor with some toys and Big A puffed out her chest and loudly told all the other children "Now don't you step on MY BABY!" (Because the only person allowed to step on Little A is Big A herself, of course.) And then I felt like it was ok to leave the two kids there and go back to work.

As for Little A, she remains the same happy little bugger as ever. But daycare seems to be messing with her sleep schedule. Today I picked her up at the end of the day and found out she had skipped her mid-afternoon nap because it was too fascinating to stare at the other kids. She fell asleep for a few minutes while I drove home, but woke up immediately when we arrived at our door and then she was ready to party again. Two hours later we were eating dinner and Little A was still going strong, waving her arms from the bouncy seat and cooing away.

"What are you trying to say to us, my little insomniac?" I asked her.

Big A looked up from her dinner with a furrowed brow. "Momma?"

"Yes?" I said.

"Why is Little A a zombie yak?"

Friday, June 1, 2007

Backstory # 4. Complications are Complicated (AKA "Why I Didn't Sue Anyone ...)

It is an (American) legal corollary of Godwin's Law: the bigger the medical complication, the greater the chance that at least one doctor will be sued. It doesn't really matter if it was true malpractice or not. It only matters if something went wrong. Therefore it's no surprise that I have been asked by numerous people if I was going to sue the OB who perforated my uterus during my D&E surgery or the anesthesiologist for my D&E and emergency laparoscopy.

When people learn I didn't sue anyone, they either express shock at my naivete, or conclude I must have found Jesus. Never mind that I'm the same old agnostic cranky pants I always have been outside of this subject. Cut me off in traffic and I want to cut you off right back, and my kids in the backseat probably just learned a new swear word, too. As for being too trusting or naive ... I'm an editor, for chrissakes. We aren't exactly known for our rosy world view.

The truth is, I thought about suing after my D&E went wrong. I think it was reasonable to do so. Usually a pregnancy termination for medical reasons is the last sad chapter in a particular sort of heart-breaking story. A dilation and evacuation (D&E) doesn't typically effect future fertility at all. While the emotional recovery takes a long, long time, from a physical standpoint, the procedure has a quick recovery time.

But with me the D&E was not the end, but the kickoff to any even more difficult set of experiences. Before the uterine perforation, I had sailed through a vaginal delivery for Big A. But the perforation placed me in the high risk, c-section-only category for future pregnancies. Then, during the laparoscopy done to repair the perf, the general anesthesia failed. I heard conversations going on about me in the OR, struggled with the pain of incisions being cut and instruments being placed, and felt like I was suffocating from the intubation tube. And since I was paralyzed from the anesthesia, I was unable to let anyone know what was happening. (See my "Backstory 3" post for more details on all that.)

Finally, while I was told that another pregnancy was likely safe so long as I waited 3-4 months to conceive, avoided labor, and had a planned c section, this turned out to be incorrect. Little A shoved her feet through my perf scar during the 35th week of pregnancy. It happened at home, before onset of labor -- an extremely perilous situation. In addition to nearly killing Little A and me, the uterine rupture also effectively ended my ability to have more children.

So ... My point is that the doctor's slip of a hand with a surgical instrument during my D&E had terrible implications for me and my family. In light of that, thinking about the possibility of suing somebody in the first raw days after my injury was just spectacular. It really, really helped me cope. I highly recommend it to anyone in a similar situation.

Any medical professionals reading this are now recoiling in horror. But, I'll say it again -- I did not sue. I'm not advocating that patients always sue. I'm just saying that the energy burst that comes with the desire to sue is good. It can wrench you free from the haze of hurt and shock and compel you to have real conversations with your doctor.Unfortunately, the type of conversations patients crave when they have bad complications scare the bejesus out of most medical professionals. But I think talking openly after an accident actually benefits the doctor as much as it does the patient. Most of the time, the patient discovers that the people working on them struggled with incomplete information. They learn that the procedure was tricky, and that what occurred was a rare but honest mistake. In those circumstances, I think the majority of people eventually come to the conclusion that they had crappy luck, but ok medical care. This is a scenario most people can ultimately forgive.

By contrast, the thing that fills you with vindictive resolve is the sense that someone is more concerned with covering their ass than helping you. If people had refused to talk (or talked down) to me after the perforation, things might have gone differently in the lawsuit department. Here's the thing health professionals need to realize: patients will assume the way you are treated after a bad complication exactly mirrors the way you were treated during the procedure that had a poor outcome. So a lot of honesty is in order. And a little bit of sympathy and niceness goes a long way, too.

The doctors who were involved in my D&E did not all behave perfectly afterwards. But, they behaved quite well. I never caught anyone in an obvious lie. Most of the time, I felt my questions were not ducked. For instance, Dr. Surgeon told me "I perforated you" rather than "Your uterus was really thin because of pregnancy, and it tore easily." Both statements are true, but the first one showed that Dr. Surgeon was not trying to deny her part in the damage. She also said, "Ultimately when something like this occurs, it is operator error." That's probably the polar opposite of what lawyers would advise a doctor to state, but let me tell you, that sentence alone really made me want to give Dr. Surgeon the benefit of the doubt.

Still, Dr. Surgeon didn't help me track down my anesthesiologist (whose name I initially couldn't recall) after I told her that I woke up during the procedure. In fact, her demeanor changed markedly when I described what I remembered occurring. She froze up, and I could almost see the thought balloon over her head that read "Oh shit, she's crazy! She's gonna sue everybody!" Dr. Surgeon told me she couldn't remember my anesthesiologist's name, which struck me as implausible, given that my perforation was a rare occurrence (first perf in ten years of the surgery, she said) and therefore likely a memorable experience. I'm sure she could have at least looked that detail up, but she never offered to do so.

Worse, Dr. Surgeon never apologized. To this day that stings. Saying she was sorry wasn't required for me not to sue. But, it would have been the decent thing to do. She caused a lot of damage. On purpose or not, it was permanent damage.

The anesthesiologist did better. I wrote him a letter describing what I'd experienced. I told him I needed to know what happened because I now had a full-blown anesthesia phobia and this was a wee bit problematic, given that I wanted to get pregnant again and was staring down a mandatory c section.

Dr. Anesthesia called me two days after I mailed him the letter. The first words out of his mouth were, "I remember your case well, and I'm so sorry. We all just wanted to help you, but it sounds like we made things worse!"He said he recalled my blood pressure was quite unstable shortly after the D&E converted to an emergency laparoscopy after the perforation. He said he had to change types of anesthesia at the onset of the lap, and then he had to immediately lighten the drugs to stabilize my BP. Dr. Anesthesia guessed that was when I was likely awake. He was ordering my chart to refresh his memory, and would call me back to talk things over again when it arrived. He said he'd try his best to help me piece together the chain of events and also give me pointers on how to relate my medical history to other anesthesiologists, so something like this wouldn't occur in future surgeries. And before he hung up, he said he was sorry once again.

The night the anesthesiologist called me was the first time in the month since the D&E when I didn't suffer from insomnia or anxiety attacks. I don't think this is a coincidence. Finally somebody who was in the room with me when everything went to crap was expressing sadness and sympathy about what happened. Even better, Dr. Anesthesia didn't try to minimize my trauma. He got that I was suffering, and unlike Dr. Surgeon, nothing in his statements or demeanor made me feel that he thought I was crazy or a wimp for feeling the way I did. He sounded like he was suffering at the thought of it all, too.

And that is how I started to move away from the idea of suing anyone. It was incremental. I got more and more information, and none of it indicated carelessness or negligence. I could slowly step away from the need to blame someone for what happened. Little by little, I accepted the notion that sometimes accidents happen. It is the most terrifying of ideas -- the concept that full control of any situation is more myth than reality. But in this case, I do think I was mostly just ... unlucky.

Complications like mine are complicated to live with. Time passing and having a healthy baby now, despite the terror and difficulties that came with that, certainly help me feel a bit better when I look back on what happened last year. But, the truth is I will never really be completely over what happened. I was permanently changed, both physically and emotionally by what occurred. It cannot be erased.

Sometimes I wonder if the doctors involved in my case ever think of me. If they do, I hope they realize that as much as it is possible for me to do so, I have forgiven them. I really do wish them well.

I also pray they are never so unlucky again with a patient as they were with me.