A friend of mine, who I was able to meet through a bereaved parents support group in our city, encouraged me to get on Instagram and explore the community of bereaved parents and grieving people from around the world. She spoke so highly of the people on there and mentioned some meaningful digital friendships she has been able to form with other women who share this sad and difficult experience of losing a child. I just started a new Instagram account out of curiosity and so far, I’ve found the posts from the different families and couples also grieving to be such a comfort. I’m also studying for my board exams (coming up in the near future) and applying for a job so things are busy these days professionally for me. I’m not sure, consequently, how often I will even be able to log in, but it’s been helpful at least initially to read of the different ways people are finding to help them cope in a healthy way with the losses of their sweet babies. Two weeks ago, I told God in prayer that I wanted to focus less on “when am I going to be pregnant again?” and “how much longer do I have to wait” and instead focusing on the following 4 priorities:
- Serving God: building a meaningful relationship with God and Jesus
- Serving my sweet hubby: building a healthy marriage to my dear husband
- Serving others: investing in a meaningful way in the specific communities God has placed me in (my church community, my friendship circles, my family, my housing community, my professional community, and globally when possible)
- Grieving the lives of my children that are now with the Lord in a healthy, memorable, and meaningful way
I think Instagram may be a meaningful tool to help me do all of these things. One such example: yesterday was a sick day for me. I stayed home and slept for almost 20 hours fighting a bad cold, likely one of these million upper respiratory viruses. I wrote 4 blog posts from bed and realized at the tail end of the day that it was national rainbow baby day. I read story after story from women who have lost children at all stages in life, mostly before or shortly after birth. While I cried many tears over the sweet and sad memories they shared of their beautiful children, I also smiled ear to ear over the joy they now held in balance alongside that pain. I felt twinges of hope that only someone “on the other side”, in the promise land, could share through a painful story of loss and triumph. I’m grateful for their courage and consider it a sweet gift from the Lord. I also realized that as lonely as this experience feels every. single. day, the truth is I am not alone. The God of the universe is with me in this valley along with the many other couples and families who have endured such painful loss.
While I don’t “feel like it” admittedly, I continue to choose to believe God’s promises to us and know that I too one day will know this joy unspeakable and the blessing of carrying new life and the birth of a sweet baby.
Today makes post ovulation day 1 and I start progesterone tomorrow.
Up until this point, most of my blog entries have been about the grief aspect of RPL and the challenges it has presented for me in my job as a physician and as a graduate medical education trainee.
You may be wondering where Hubby and I are now in our efforts to start our family. We lost our last baby this past April 2018. I really and truly did believe that baby was going to make it. And when I started to spot and my heart sank, it was one of the most demoralizing and depressing experiences I have ever been through. We met with our RE in May and was told that she is very confident that we will get pregnant with our rainbow baby and she does not think we need to do anything different. That baby we conceived on 100mg of clomid. The other 3 we conceived on our own. I ovulate regularly on my own usually days 14 – 16. She thought trying clomid for a few months may help to “boost” my ovulation and allow me to ovulate more mature eggs. We have just tried clomid 50mg for the past 3 cycles and are doing clomid 100mg for this present cycle. I was confused on the instruction and I did clomid 75mg for days 2 and 3, then clomid 100mg for days 3, 4, and 6. I just got a positive OPK yesterday so we are in our peak fertility period. After ovulation, I’m supposed to do progesterone suppositories twice daily for 2 weeks, then take a pregnancy test. If it’s positive keep taking the progesterone and if it’s not positive stop progesterone and wait for my period.
So Friday I will start the progesterone. I usually get excited around this time in anticipation of possibly getting pregnant again so I’ve been very hopeful all week! Two years of TTCing and I still struggle to have patience during the two week wait (TWW) from ovulation to the end of the cycle and hopefully positive pregnancy test. When you are on both clomid and progesterone, you have all kinds of symptoms that often feel pregnancy -related and may not be. So with that, as of last cycle, I decided that I would stop testing early henceforth. I will wait until the end of the cycle and take one test. I’m so praying that this be the month that we conceive our rainbow baby. I am hoping and trusting in God’s faithfulness. I’m also hoping that this blog will help me stay sane and be present each day of the TWW. We have many fun things coming up in the near future including 2 vacation trips, time spent with family, and a day trip or two. I’d like to focus on those moreso than the persistent question, “am I pregnant?”. Cheers to us waiting together!
One challenging aspect of our living with RPL and the pain of grief has been balancing that with my duties as a “fellow” in my medical subspecialty. For those who are not familiar with medicine, after generally 4 years of medical school, most new physicians embark on what is termed residency. This is a period of 3-7 years (depending on the specialty) where you learn how to be a subspecialty physician in the area of your choosing. This includes all of the areas you can think of ob-gyn, pediatrics, family medicine, internal medicine, general surgery, plastic surgery, etc. After residency, if you want to sub-specialize even more (I.e. become a pediatric dermatologist, or a pediatric allergist, or a breast surgeon, or a colorectal surgeon, etc) you have the option to do what is called a fellowship: an additional 1-3 years of training under leaders in that specific area of medicine.
I am currently doing a fellowship in my medical area of interest. Miscarriages are seldom discussed in our society and certainly NOT in medicine. So when we experienced not one but 4 early miscarriages, I’ll be honest in that I did not know who I could talk to or where to go for support. There were days that I was in such pain, I had a hard time focusing on my work responsibilities. The area in medicine I am in does not have direct patient care most of the time; I’m usually “behind the scenes”. I imagine that my teachers/attendings, who had/have no idea what we are going through, may have interpreted my performance as les than adequate at times and maybe even misinterpreted my continued sadness for disinterest in the sub-specialty, lack of motivation, or even distraction. I go home at night and I don’t study but I either cry on my couch for several hours talking to God about the pain in my heart or I read blogs on miscarriages and recurrent pregnancy loss and then cry for hours and talk to God about the pain in my heart. I sleep, wake up go to work and repeat most days.
I wish there was a place in medicine to manage the aftermath of RPL. I wish there was a way to be able to grieve openly free from shame and the fear of professional repercussions in the future if people know you are trying to start a family during your graduate medical education training. Most physician mom blogs or websites I go to are filled with posts on how to be a mommy in medicine. Seldom discuss how to grieve the loss of a child in medicine. And yet, I have a feeling that I am not the first nor will I be the last resident and fellow to experience the pain or miscarriage. I only wish in medicine we could have open discussions about how to support our trainees who experience something like this. Perhaps a support group or website with a forum… right now to my knowledge there is nothing… I’ve thought about trying to start something to meet this need but where is the time?
With my board exams about a month away, one may think that I would be neck deep in studying for it. I have been studying intensely for it but I have also had a difficult time keeping my mind from wondering what our next steps are in our efforts to TTC and wondering how I will balance celebrating my 2 girlfriends pregnancy while nursing my wounds of bereavement. It’s been tricky business to say the least and I’m not sure I’ve figured out “how to do this” yet.
One thing that this journey to try to start our family has shown me is that as a doctor, we too are patients sometimes. I’ve had to sit and wait in the examining room with fluorescent lights and pale walls for good news or bad news. I’ve had to muddle through answers that did not bring comfort such as, “I’m so sorry; we just don’t know”. I’ve dealt with physicians and clinicians with a variety of bedside manners too. Some who’s body language came off as detached and aloof and others who were so supportive. I’ve been tasked with trying to determine if I wanted to pay blah-blah-blah hundred dollars for a test that may or may not change anything. And what about insurance? What a black box! I can barely figure out if my insurance covers certain services and am constantly surprised oddly enough when I receive yet ANOTHER bill in the mail for something that was not covered. Its really no wonder that our patients so often feel lost and confused in our healthcare system. I feel like I need a “health navigator” to help me figure out my own health finances. How do patients with sick loved ones (children, spouses, parents, friends) cope with the tough decisions and the details? It seems impossible to me and I empathize all the more with others in this circumstance.
I may have an MD and I may be a doctor, but I too am human. I am a woman. I am an immigrant. I am a Black American. I am a wife, sister, daughter, and friend. I am a bereaved child who lost her mother at age 21. I am a bereaved mother to 4 children that I will have to wait to meet in heaven. I am a Christian. With all of these aspects of my identity, I too endure the challenges, stresses, and pain of life in this imperfect world that we live in. My professional title has not made me immune to the pain that many of my patients endure. And as such, I hope this experience of recurrent pregnancy loss (RPL) will change me for the better ultimately. Though with tears in my eyes and the deep wounds in my heart I pray that it continues to make me more sensitive to those around me who too are living with the stress and pain of diagnoses that feel too big for them to handle.
I’ve realized that medicine will always have limitations as painful as that may be. We in medicine have many answers but we unfortunately do not have all of the answers and that’s ok. Because we too are human and have a variety of limitations not too dissimilar from the limitations of the patients we are taking care of sometimes. Your doctor may never tell you the pain and sadness he or she is weathering in their 15 minute clinic visit with you. What is your doctor not sharing with you: about the disease they are dealing with, the depression or anxiety that has plagued them for years, the loved one they recently lost, the stressful marriage or relationship they are trying to navigate? While taking care of patients in clinic I have snuck into the bathroom on more than one occasion to engage in a cryfest for a few minutes. I wash my face thereafter and hope no one notices my reddened eyes and puffy eye lids. I certainly have never told my patients of the pain I carry with RPL.
This realization that as a doctor I too am human has made me more grateful, believe it or not, to have a God that understands and is in control of things at all times; even when medicine fails us, He will not. His control does not have to make sense to me, and often times, let’s face it, it seriously doesn’t lol. It doesn’t make sense because He looks at who I am in the grand scheme of time, the person I will be 30 years from now, and the impact I will have on the world around me. He knows that certain experiences will help me develop certain character traits and skills to fulfill my calling and destiny in life. So I don’t have to burden myself with “knowing” or “understanding” something as complex as RPL. I am choosing instead on learning how to live a productive fulfilling life in spite of it… I have not figured out how to do this last part yet but I am praying about it and taking my efforts one day at a time 🙂
When I initially started this blog a year and a half ago, it served the purpose of documenting our new pregnancy and I anticipated it serving as a way for us to share updates, photographs, ultrasound pictures, etc with our family and friends scattered around the country. I picked out the name of the block and started to draft the first blog entry. Well that dream was not realized and after fast forwarding to now, we have been pregnant 4 different times and lost each baby from 4+weeks – 6 1/2 weeks. They call this “recurrent pregnancy loss” but in reality it’s loss of more than the pregnancy. You lose. You lose your baby, you lose the hopes and dreams you had for him/her, you lose in part your identity as an expectant mother (or at least it changes), you lose your relationships to family and friends who either don’t understand the pain you are walking through or don’t know…. It changes your intimacy in your marriage and your relationship and friendship with your spouse. It changes you. It changes your spouse. You become this new person, but the new version of you feels like a complete and unwanted stranger most of the time.
For the past 2 years, trying to start a family has been at the forefront of my mind constantly: when will I be pregnant again, when will I anticipate having the baby, when can I take maternity leave, how will I tell others, who will I tell, when will I tell them, what will I look like ___ months pregnant, how will we plan the nursery. While these questions are appropriate questions for all trying to conceive (TTCing), I also find them super exhausting these days! You know why? Because I haven’t the faintest idea the answers to any of them! Sometimes I ask God some pretty tough questions (when does all of this pain actually end?). But I’ve realized that if He wanted me to know the answers, He would tell me. And if He has not shared them with me, it’s probably because the answers are not relevant today to the big picture of our life story.
So this blog represents a new take on my part: my efforts to indulge in and ruminate about things that I can change and I can control today. I’m excited to go on this journey! Oh yeah and by the way I kind of have a habit of “starting” things and seldom finishing them (I have a TON of ideas, seriously)….. I hope that this blog will be an exception to that hah ;-)!!!