New Year

2014 started with storms — snow angels in the nearby park, ice floes on the Hudson escaping the city, snowshoeing and sledding in northern parts.

Rain.

It seems like there was a lot of death this year, big heaving tears and, somewhere in there, reinforcement of the belief that, truly, we humans are at the core beatific. An unhinged time in early summer of traveling every weekend. Weddings and graduations and funerals. Sunshine and very long drives and unpacked bags and digging for the right dress giving way to growing plants, open windows, rooting.

Fall rolling in consumed by yoga teacher training and being pregnant, a combo that took up pretty much everything, but in the best possible way. Protests. The tug of change and revolution.

2014 ended with holidays at home, more walks in the woods than usual, listening intently to the quiet. 2014 ended on my couch in Brooklyn with good food and warm slippers, fat and happy with soon-to-be-baby turning somersaults in utero because I ate too much sugar. Ended as it always does, with pangs of anxiety at the 10-second countdown, like there was more I meant to do, like I didn’t reflect enough or fit the jigsaw piece of that year properly into all the rest. So here I am, two days later, noting the steady march of loss and life, whirlwinds and quiet, picking through the things I loved in that year and the things that I learned. Remembering that I can do it a day or too late, resolving in the new year to believe that it’s never too late.

Looking forward to all that the next year holds.

Hospice

I spent the last couple of weeks helping to care for my Grandma who’s on hospice in her home. First with my mom, then on my own, and then with my mom for one more night before leaving. She’s still there, my mom, doing a bang up job of caring for her own mother in her final days. I don’t think my mom feels very graceful these days, and I know that sometimes that sacred thing of being with someone who’s crossing over feels anything but holy, more flailing and surreal than anything. But it was special being with these ladies lately, and my momma is a marvel. A sleep-deprived, strung out marvel.

I got back to Brooklyn last night. I said good-bye to my grandma yesterday, don’t think I’m going back until it’s time to organize a memorial service and parse out her things. She is on her way out for reals this time. I noticed a difference in her even being gone for a couple days last week. She was sleeping more of the time when I got back, awake very little, still lucid but talking much more from dream state. Saturday night, she spiked a fever of 103+. She was in pain and shaking like crazy and said “it’s starting.” I gave her morphine and called the nurse and crawled into bed with her and held both her hands in mine. She was shaking so badly she could barely talk, but with the little articulation she could muster, that woman made me laugh. I told Shawn that in time, with more perspective, other memories of all our time together will come to the forefront, and the one that feels favorite will cycle through, but for now, that is it: My grandma making me laugh on the cusp of death. I’ll tell you about it in person if I see you. I’ll tell it a million times. That was our last conversation. She’s been sleeping since Saturday, fading away bit by bit. At first, she’d still give me the slightest nod when I said that she looked peaceful. She murmured a couple of sentences. She opened her eyes and blew a kiss when a very, very old friend came to say good-bye. She swallowed her pain meds without me hovering and coaxing. But it all kind of faded out over the last few days. My mom said that she is a tiny boat out on the ocean now, and no metaphor has ever felt more apt or true.

My mom came back Tuesday. I was supposed to leave that afternoon, but I changed my ticket so we’d overlap by a day and have some time together. It felt weird to leave. I felt so invested in caring for my grandma that it didn’t seem right to leave before she died. But it will probably be easier for her to slip away without me there needing so badly to take care of her. I wished her a peaceful and easy transition. I blubbered all over her. I looked for signs of responsiveness, hunched shoulders and twitching hands showing agitation, and took it to mean that she heard me and was also sad instead of the other option of being due for another dose of meds. I said a tearful good-bye and then saw her eyes cracked open when I left the room, unseeing, hands twitching, and I spoke calmly and clearly like I had for days and coaxed in meds and a dropper of water one last time, smoothed her hair, said good-bye again.

And now I’m back. I don’t understand how the body keeps going. When she fevers, it is almost pure salt now. Mom texted “gramma much the same. peed a bunch in the night. HOW?” and we both wonder where the fluid is coming from. Her vitals are still bizarrely good, but she is very close to gone. She looks peaceful. I took good care of her. My mom and the nurses keep saying that I took really good care of her. The high school friend who came for a heart-wrenching good-bye was so glad that her nails were done and that she was clean and that she looked at peace. Her original hospice nurse who had to go on leave for surgery of her own came to visit the other day, and she said “this is as good as it gets.” My grandma sleeping peacefully, removed from pain, in her own bed, cared for by people who love her.
                                                                           *
It’s as good as it gets. I’m really, really sad. I’m deeply grateful for the experience of caring for her. I feel blessed that her last conversation was with me, under the covers in my Grandma’s bed like so many of my favorite early memories, but listening better, holding both hands.

Some Things About My Grandma

I wrote this in June, and never published it. All still relevant, except that my Grandma had a birthday and is now 89.

When my grandma would visit when I was little, I’d crawl into her bed as soon as I woke up, and we would tell each other what we’d dreamed in the night.

No human being alive loves any one food the way that woman loves raspberries. She speaks of them with reverence. She never misses  a meal, does not snack, and has two cookies after dinner.

She taught herself to tap dance for her 80th birthday party. She wanted to learn something new. She wanted to put on a show for her friends. She wanted to make “80 years young” a thing. I heard she rocked it.

Well into her eighties, she took me on a trip to Eastern Europe. We swam off of cliffs in Dubrovnik, she in good leather sandals, which really were the worse for wear afterwards. No regrets on Grandma’s end.

She saves letters — all the letters my mom wrote, and the letters that I have written, letters upon letters from friends and family. She tells me my stack is the highest, and my heart breaks, feeling like I should have sent so many more.

Her father and grandmother were great teetotalers. The first time my Grandma was invited on a date to a bar, she ordered a Tom Collins without batting an eye. Now she likes to order Sex on the Beach. With a wink and a laugh. She thinks it is hysterical, an old lady ordering such a thing.

She danced more at my wedding than anyone there.

There are a million more things about my Grandma, like how, when my older brother was born, she used to go out after dinner and walk as fast as she could to try and escape how much she missed her first grandbaby, or how she worked while my Grandpa was in college, decades before woman breadwinners popped up in headlines, or how she loves me, just fucking loves me, or how she’s a fierce advocate for people with mental illness and their families, or how she does exercise videos taped off PBS 15 years ago, using soup cans as weights in a pinch. Margaret Richards forever. Or the smell of her laundry room, the smell of the garage in her old house, the way the air felt in those bedrooms, sun tea on the back porch, her curly handwriting, the first time I ever had homemade waffles, her silliness, sweet silliness. Little these things floating up.

I realized just today, even though she is 88 years old, that I always thought she’d live forever. She has whitewater-rafted in Utah, gone heli-hiking in Canada, traveled to Thailand, Turkey, China, boated down the Amazon and cruised through Europe. She’s ridden trains, planes, elephants. She’s danced her heart out. She’s kicked my ass at countless card games. So much to celebrate. As soon as I stitch myself up. My Grandma is sick, suddenly really sick, and she is alone, and it hurts like a gaping hole in my chest.

This Shouldn’t Be So Weird & Scary: Thoughts on a Miscarriage

I barely slept the night I found out I was pregnant, having read that my baby was somewhere between the size of a lentil and the size of a blueberry and already forming a face. I was blown away by the insane miracle that human life happens, that microscopic cells divide and grow and become a person, that chromosomes meet up and have the coding to know what to do. Turns out the chromosomes of my lil’ babe didn’t totally know what to do, or maybe its coding didn’t quite line up. Either way, it didn’t make it. Only three out of four really do.

I had a miscarriage at just shy of seven weeks. I was elated about the pregnancy. The loss was sad for sure (though I count myself very, very lucky that it happened so early), but what hit the hardest during the miscarriage itself was the extent to which I did not know what was going on with my body. In that sad and confusing time, the wisdom of real life ladies proved far more helpful to me than my doctor’s advice. I am lucky to have friends who will get all gross and nitty gritty about these things, and I am lucky to have friends and family who helped me firm up my shaky decision to follow my gut over my doctor’s advice (not something I’m advocating, but it was the right choice for me that day). Everyone should be so lucky.

What’s weird to me is how little people tend to talk about miscarriage. I’d heard very few miscarriage stories from friends and family prior to my own. Once I brought it up, so many more materialized – if not friends’ own stories, then their aunts’, mothers’, cousins’. It’s crazy to me that there’s any kind of stigma around talking about something so common. At least a QUARTER of pregnancies end in miscarriage. It happens all the time. I don’t say that to scare newly pregnant mamas-to-be. On the contrary, I think there’s a way in which silence provides cover under which fears can hide and grow, and talking about this stuff feels to me like dragging those deep fears out into daylight, letting them air out and fade in the sun.

Sometimes the hush is understandable and necessary. Not every woman wants to talk about her miscarriage. It can feel quiet and private, too painful to broadcast. But I am doing OK, and as such, it seems worthwhile to raise my hand, to say that this is something that I experienced, that I am fine, and that it doesn’t have to be quite so scary and weird to talk about. I’m writing because the silence about miscarriage felt so heavy to me when I was having one, and I want to lighten it up a little. This is absolutely not intended to replace or override medical advice – it is simply a collection of things I learned. I’m sharing in hopes that it will reach a woman out there who’s as confused as I was, new to pregnancy and bleeding, not sure which end is up. Imaginary woman, you are part of a long line of women who have been through this. You are not alone. I hope you have friends who will talk to you about even the ickiest parts. But even if you don’t, or even if they’re all asleep right now, you’re not alone.

Are You Actually Having a Miscarriage? What I Learned About Bleeding

I’ve yet to hear of a woman experiencing miscarriage the way it frequently happens in the movies and on TV – a sharp pain that triggers the woman to reach into her pants with her bare hand and bring it out covered in blood, immediate confirmation that things have gone awry. In real life, there is a lot of gray area, symptoms that could be OK or could not. Plus, most women don’t reach blindly into their undies when things don’t feel right.

It turns out lots of women have spotting during pregnancy. It could be something minor going on with your cervix. It could be implantation bleeding. It could be miscarriage. My sources on the interwebs concur that spotting that is pink or brown is less likely to indicate a problem with pregnancy. Bleeding that is bright red or heavy, or bleeding with clots is more likely bad. Pain is also a bad sign.  If you are experiencing any kind of spotting or bleeding during pregnancy and are reading this online, odds are the internet has already told you all of this.

But what is spotting? And what is heavy bleeding? What constitutes a clot? This is where I felt most in the dark and where the internet really let me down. There seems to be an expectation that we are all on the same page and inherently know the difference between spotting and bleeding and can easily fit our symptoms into neat little boxes. But here’s the thing: If you have any blood coming out of your vagina during pregnancy, it’s probably going to be alarming. There’s a good chance that any blood at all will seem like a lot of blood. Mine was bright red, a red flag if you will.  Because I was looking at one bad sign, it seemed like I was seriously bleeding. When I called the nurse line provided by my insurance, she asked me a slew of rather clinical questions that I found myself unable to answer until I pushed her for definitions. This struck me as completely backwards. We should get the definitions before the questions, or the questions should be open-ended with room for descriptors. Questions with yes/no checkboxes that have not been explained were not particularly useful to me. I thought I was bleeding heavily, but when I finally got the phone nurse to define spotting, it turned out that fit the bill for me (no need to change a panty liner within 4 hours).

And then there’s the issue of clots. I could not, for the life of me, get a good definition of what constitutes a clot. If anyone has one, please post it here. There was stuff in the blood, but there’s always stuff in the blood when I have my period. The knee-jerk response seemed to be that anything other than pure liquid meant that I should go to the ER immediately, but I was not convinced that the stuff in my blood signaled danger. I had some pretty comprehensive sex education growing up, but I found myself wishing it had been even more graphic. I found this handy video about different sized clots in menstrual blood (spoiler alert – if you regularly have golf-ball-sized clots with your period, you should get checked out), but nothing about lumps in pregnancy spotting. A friend told me she always thought she’d had clots in her period, but that her miscarriage was different – she had a slight fever, and the clots were way bigger, even though she was very early on. That gave me some comfort for a little while since my lumpy stuff was all pretty small, but there was enough of it that I grew pretty sure over the course of day one that my pregnancy was ending (p.s., unlike in the movies, miscarriage is not usually a one-time gush, but something that sticks around for a little while). In the end, I never had anything major – no huge chunks, no heavy bleeding. It was almost exactly like a light period. It’s different for everyone.

Hospital or No Hospital?

I started spotting at 6am, too early to talk to my mom or my friends, also too early to call the midwife’s office I’d identified via Yelp as a potential good fit. And so I turned to the internet. One of the first things I’d read, when I’d moved on from Googling “spotting in first trimester” to straight up reading about miscarriage, was a story about how it’s possible to be OK after miscarriage. The things that the author found comforting were the very things I’d included in early morning text messages to my mom, the reasons I’d given myself to be OK if I was indeed miscarrying. Buried within one of many comments on the post was this:

“I wish at the time when I’d been scouring the internet in a late night haze that I’d come across something that had said, MISCARRIAGES ARE VERY COMMON AND UNLESS YOU’RE GOING THROUGH MORE THAN 2 PADS IN AN HOUR, YOU CAN WAIT IT OUT AT HOME.”

Once again, I am not dispensing medical advice. There are some really good reasons to go to the hospital during miscarriage. If you’re in major pain or hemorrhaging, it could signal a serious problem and could indicate that your health is at risk, not just your pregnancy. If your symptoms are more tame, but the anxiety of not knowing what’s going on makes you feel like you’re going to jump out of your skin, go and get yourself some answers!

My morning was a whirl of trying unsuccessfully to find medical care that was not the ER. My gynecologist had moved, leaving me between lady doctors. I called a potential new OB/GYN office and explained my symptoms and asked if I could come in. I was told to go to the ER. I called the nurse line offered by my insurance. She did not specify ER, but said that I needed to see a doctor “within the hour” (something that has never once happened in my history of emergency room visits). I went to see my GP, whose office is around the corner from my house and who takes walk-ins. I explained that I knew he couldn’t do anything for me, but that I hoped he could call up an OB/GYN and get me in fairly quickly. He called up his gynecologist buddy and described my symptoms. The buddy told me to go to the ER. Well, not exactly the ER, but the OB on call at the ER, which is pretty much the same thing. My doctor gave me a note to try and speed me through the waiting process at the hospital.

Here’s the thing: I had mild cramping, sometimes waves of pain, but it felt like period pain, nothing worse. The insurance nurse had helped me understand that I was spotting – nowhere near hemorrhaging. The reason I was told repeatedly that I needed immediate care was that I had some tissue in the blood. But wouldn’t any miscarriage involve the release of tissue? And hadn’t women had miscarriages for thousands of years without the aid of the ER? My gut sense was that I was OK – that I would be in more pain or have a fever or even more alarming symptoms if I was in any danger. It was the first hot day of the year and happened to be the day that my local botanic gardens offer free admission. Wouldn’t it be better to take my sadness there, to get some sun and stare at flowers, than to sit alone in a hospital, most likely for hours, waiting for an ultrasound to tell me whether or not there was a fetal heartbeat? This early in pregnancy, it would likely be a transvaginal ultrasound. A cold piece of machinery in a rather invasive spot did not sound like it would be a comfort to me.

Finally, I spoke to a doula friend who gave me the number of a midwife. The midwife said, “I’m so sorry” when I said I thought I was having a miscarriage. She listened to all of my symptoms and said she could see me on Friday. I mumbled my speculations regarding the advice to go to the ER: “All they’ll do there is give me an ultrasound to confirm whether or not it’s miscarriage, but I’ll most likely know in a few days on my own, right?” She said most likely, “And if there was a concern about ectopic pregnancy, I’d have a lot more pain, or pain on one side, or a fever or something, don’t you think?” Again, she said most likely. I was hoping for a solid “yes,” but there are liability issues when giving medical advice, and this was the closest confirmation I was going to get that I was probably OK.

My husband and my mom both supported my decision not to go to the ER. Friends who’d had miscarriages said I might not even be having one (a short-lived comfort, but a lasting bit of perspective on how not terrifying my symptoms sounded to others). I took my doctor’s note in case anything changed for the worse and went to the botanic gardens. A dear friend was able to join me and hug me and stand quietly beside blooming magnolias – soft, pink ones that look like frizzled fireworks, luxuriously creamy saucer ones set off by dark branches and a bright blue sky – to lament that the cherry blossoms weren’t out yet, to watch the turtles swim lazily and lie out on rocks, basking in the glory of that first hot day. I cried behind my sunglasses. I stood in the sun. I laid out in Prospect Park and talked on the phone when my friend had to leave. It felt better than being inside.

I continued spotting for a few days and kept my appointment with the midwife later that week. She gave me a prescription for a sonogram in case my blood work was inconclusive, but, when the results came back the next day, she was able to confirm that I was no longer pregnant (my hCG level was far too low).

If you don’t know what’s going on, talk to someone who knows more than you. Talk to a mother or an aunt, a friend who’s had a miscarriage. Talk to your OB/GYN or your GP. Use Yelp to find a midwife who answers her own calls and can listen to you describe your symptoms. But listen to your body, too. If you feel OK, you are probably OK.

Some Things That Helped

Hands down, the thing that surprised me most was how calm I was during my miscarriage. I tend toward anxiety (honestly, who doesn’t?), and I was surprised during my brief pregnancy by how fearless I felt. Granted, I didn’t have a ton of time for my mind to go to dark places, but I really didn’t consider the possibility of things going wrong. When things did go wrong, I was confused and upset, but I was surprised to find, somewhere at my core, this belief that things were unfolding as they were meant to, that I was going to be OK.

I’m not a particularly religious person. I love me some yoga. I believe in spirit. I don’t think much about fate or what’s “meant to be,” but I had this feeling in my gut that if I was indeed having a miscarriage, it was because the pregnancy wasn’t meant to be. This little dose of spiritual wisdom came from a most unlikely source: WebMD. It was there that I first read that “most miscarriages that occur in the first trimester are caused by chromosomal abnormalities in the baby.” I probably hadn’t done anything to harm my baby. Most likely, there never was a healthy, fully functional little embryo at all, but one that never had the necessary equipment to become a full human being. I’d been astonished by my ability to love something so small, sight unseen. It turns out it was something different than I thought it was, something too flawed to make it. Odds are, it was never going to be a baby. I was grieving a dream. Somehow, believing that was helpful.

I’d been trying to get pregnant for quite a while. For women under 35, the recommendation is to try for a year before seeking medical advice. It could take a month, it could take 11. I fell well within normal range, but it had been long enough that I was starting to wonder if I could get pregnant. Even though my pregnancy was short, learning I could get pregnant was a positive thing. Miscarriage is incredibly common and does not in any way indicate that something is wrong with you. The lesson learned, that I’m releasing eggs, that my husband’s sperm know where to go, that they can meet up, is a really great lesson that still holds true, as does the conviction that came in a new and solid way with pregnancy that being parents is something my husband and I both want.

Somehow, the fact that miscarriage is so common and that most women who have a miscarriage go on to have a perfectly fine baby made it all seem like a step on a path, a page in some future book about being a parent. I felt this way even before I received the most perfect email in the world from a friend who’d been downright jubilant when I told her I was pregnant. If you are having problems with your pregnancy and fear miscarriage, plug your name right in there in place of mine. My friend would want it that way.

Sweet Megan

Your baby – the one that has or will make their nest within you – now knows the delight with which you will receive her/him.

Any doubt has been washed away.

Yes for sure there is a soul throwing a party.

This is part of conception – a tender, hard, heartbreaking part, but part of your pregnancy journey, and it is still really really exciting that you are on this path.

I wish I could hug you right now but I am sure you are being hugged.

Magnolias was a brilliant choice.

I wish you flowers and the comfort of friends, grief in whatever way serves you, and a million babies if you want them.

For Now

Sometimes I joke about my blog graveyard.

I had a blog about crafty projects and cooking and the farmer’s market. It was a good time, but I outgrew the name, writing was redirected, and it fell by the wayside. There’s some good stuff there, but I haven’t said anything in the last couple years.

I had a blog about wedding planning, which I really used as a planning tool until we set up our wedding site and got all up on google docs.

I had a blog about yoga and bodywork that I ultimately merged into my work blog, which is still current (the former is now hiding behind privacy settings).

I feel a little guilty starting yet another blog, but some stuff is just miscellaneous. Some stuff begs to be said without obligation to say more. Some stuff is personal and, however bodily, does not belong on my bodywork site. Some things need a home.

So here I am, a working draft of a person (aren’t we all?), jotting down the miscellany that I otherwise might not know how to say.