A Slow Burn

One of my more visceral memories from childhood comes from when I had chickenpox.  Age-wise, I’m among the oldest Millenials and I got it before the vaccine was widely given.  Mostly, what I remember is the incredible itching.  I had gotten a full-blown case, spots everywhere with fever, but no major complications.  “Don’t scratch,” my dad told me.

“But it ITCHES!” I wailed.

“You don’t want to get infections and scars, especially on your face.”

“I DON’T CARE IF I GET SCARS!”

“You will when you’re 16.”

As I grew up, though, I read more about diseases like polio (author Peg Kehret’s Small Steps: The Year I Got Polio is a well-written, YA-level account) and mumps and measles.  I shivered at the horrific accounts of the Spanish Flu and did high school reports on the Black Plague.  I was glad that I never had to experience them, and even as my belief that medical science could conquer almost anything faded quickly, I felt fairly secure.  I rejoiced when the girls got their chickenpox vaccines, that they wouldn’t have to know even a week’s itchy misery, let alone the more serious complications.

~*~

After E got home from the NICU, we were under quarantine for a year.  I was allowed to take her to medical appointments and occasional shopping expeditions (where I kept her covered in her car seat and sanitized virtually everything we touched).  Arthur went to work and did everything he could to stay away from illness, as did I.  I had an elaborate routine post-shift of changing at work, washing any exposed skin from my shift, my scrubs sealed in bags and washed separately with the washer bleached afterwards.  E and I didn’t go to church, and after his second job ended in the early fall (before cold/flu season), Arthur didn’t either.  We didn’t go to gatherings (with the exception of my brother’s memorial service, where the worry E would catch something added to the general awfulness of the situation).  I used to take E for walks in the fresh air when it was nice, social-distancing ourselves by at least 3 feet from other people before the term entered the lexicon.  We had hand sanitizer stationed all around the house and my hands were often dry and cracked from washing.

All this to say, these precautions aren’t totally new to me.  The fear isn’t new.  The isolation isn’t new.

It’s a deep breath and the slow burn of anxiety as we wait in ways I never thought we’d have to do again.

~*~

In my house, we are all low-risk as possible for the serious complications and doing everything we can to be responsible citizens to prevent the virus spreading/complying with social distancing.  I know the virus can be severe in younger people as well and we are not by any means taking that potential lightly.  Strangely, I’m less anxious about working in health care than I would have thought – but, then, I’ve known since long before going to nursing school that communicable diseases were a risk I had to assume if I chose this field.  Obviously will be following all guidance closely and extremely careful complying with all personal protective equipment/isolation requirements (as always).

I am definitely worried about my parents, friends, my last surviving grandparent, all the elderly/immunocompromised and what happens next.  Reading about Italy’s current situation is almost overwhelming in its awfulness and the decisions that I suspect we will shortly face in many other places.

I know that experts have long modeled and predicted pandemic scenarios, but in day-to-day life, it’s felt easy to rest secure.  There are so many things to worry about just in a normal course of existence.  This one really didn’t make the cut in my head.

Yet here we are.  I gave blood on Monday – one tangible thing I could do as someone who’s eligible, currently healthy, and has a blood type in high demand.  Now we take the precautions recommended by the experts, comply with public health recommendations, check in with people by internet/phone, and wait.

Waiting, as I think we all have experienced in various ways, is far tougher than most people give it credit.

That’s My Story and I’m Sticking To It

In my 20s, I attended a fair number of baby showers and pregnancy/childbirth-centric events.  It’s like a bad take-off of the Jane Austen line, “It is a truth universally acknowledged…”…that if you are a married woman in your 20s, you are interested in conceiving/pregnancy/birth.  As someone who was at best ambivalent about having babies (oh, the irony) at the time and more focused on going back to school, I found this emphasis frustrating.

When I arrived at 30, suddenly in a tearing hurry to have babies and getting into increasingly expensive, painful interventions that seemed to fail at every turn, the amount of social pressure turned into something far darker.  While there are areas of the US where women in their 30s having first babies is the norm, where I live, I was one of the oldest people in my peer group married with no kids.  Most of my friends have older kids, including a kid who is a teenager currently.

In the throes of infertility, I quit going to baby showers.  I stayed out of heavily female spaces because it felt like pregnancy/childbirth stories came up a surprising amount as a bonding activity.  I figured one day I’d get wherever “there” was to feel emotionally secure enough to start attending again.

I had the kids.  And then something strange happened: I still don’t belong.  Not really.

There’s more room for sharing of “less than optimal” experiences now than perhaps there once was, but there’s still a pretty heavy social price for relating certain parts of stories.  I’ve personally primarily experienced this in regards to miscarriages/pre-viable PPROM/NICU – so that’s what I’m writing about here – but I also know this happens in some very difficult ways in the infertility community as well for people for whom treatment doesn’t work or adoption doesn’t happen (because this isn’t my story to tell, here is an excellent blog post on that subject, as well as here).

The first time I naively waded into a discussion after my older daughter was born, I simply spoke part of the truth: that I’d been in the hospital for quite some time after my water broke at 21 weeks, the doctors thought the baby wouldn’t make it, I somehow stayed pregnant until 28w4d, and E was born, spent awhile in the NICU, and was now doing pretty well.  Never mentioned the infertility/IVF/miscarriages or the messiness of the subchorionic hematoma/hemorrhages.  I actually watched someone’s mouth drop open.  People weren’t sure what to say.  There was some shuffling and looking down and the subject got changed.  It wasn’t the last time this happened.  Eventually, I started being a lot quieter during these conversations.

“It’s like I’m Stephen King giving a speech at the romance writer’s convention,” I once quipped to Arthur.  I’ve also heard more than once complaints about how people love to tell expectant women the worst stories about infertility/pregnancy/childbirth and scare them.

Obviously, there’s an element of knowing your audience here and being polite or sensitive.  I don’t tell anxious pregnant women my story because of this, because they’ve got enough concerns going on.  There are times that people can’t handle certain stories and I get that.

But other times, there’s an element of silencing.  Stories that are too uncomfortable and too taboo to tell out loud.

As I was reading Sarah DiGregorio’s book on prematurity Early, a passage helped crystallize the vague sense of not-belonging I’ve felt at times: “I also didn’t want to be the bearer of dark information, and I couldn’t imagine how I would participate in ‘normal’ conversations about my baby.”  DiGregorio also notes that “The emphasis on ‘natural’ birth that is meant to be empowering can be painful for those of us who needed every unnatural intervention to get our babies (and/or ourselves) out alive.”

I hear that.

I know that I’m (thank goodness, as I wouldn’t wish this on anyone else) an extreme outlier to plenty of statistics.  Of people who struggle with infertility,less than 5% go on to use IVF according to the ASRM.  Subchorionic hematomas are one of the most common reasons for first trimester bleeding, but very few are anywhere near as problematic as mine turned out.  Periviable PPROM affects only around 0.4% of pregnancies.  While preterm birth is an enormous problem in the US, only a little less than 2% of all births and around 16-20% of preterm births are before 32 weeks’ gestation.  In other words, my experiences are definitely not the norm. I don’t think policies or procedures or public health should be based around women like me.

But the suggestion that anyone can (fill in the blank: get pregnant without intervention, get pregnant with intervention, prevent a miscarriage, give birth without certain interventions, prevent a c-section, etc.) has the weird effect of sort of erasing people like me who don’t fit into those narratives that we are ultimately in control.  At times, I’ve found it also can have the effect of almost turning my story into a spooky fairy-tale, the thing that lurks in the shadow, the uncomfortable specter at the feast.

It’s a tricky thing: I want women to be empowered to seek answers and have authority over their own bodies, I want to see fertility treatments covered by insurance but not hailed as ‘the’ solution to infertility, I want as many miscarriages as possible prevented but women not blamed for miscarrying, I want to see unnecessary c-sections curtailed and more choices for women but also the understanding that c-sections can be life-saving preserved, I want better public health to help prevent as many pre-term births as possible and also better NICUs/treatments for those that happen anyway, I want campaigns of information that can help people avoid bad outcomes but don’t ‘other’ or shame those that don’t fit or have less than optimal outcomes anyway.  I did nothing wrong and yet so much went sideways for me.  There was no extra prenatal care or information that would have helped me, there were d*mn good reasons I had c-sections, and I get very tired indeed at times of explaining why (fill in the blank) would not have prevented this, the suspicion that I had to have done something to make this happen because surely these things are preventable?

I don’t know the answer here.  I don’t know how we make space and genuine understanding for all of these realities.  Telling stories is a starting place, I suppose.

Variety Is The Spice Of Life

microblog_mondays

It’s weird how time passes – the minutes or hours often seem long, but then suddenly, I’m in the middle of a new week or a new month.  What I’ve been doing with those minutes and hours is a mishmash:

  • Finished painting the basement. I have cream paint down the stairwell and along one long wall, then a sea-glass green to the other three walls (Benjamin Moore Windswept and Robin’s Nest if you’re curious).  It feels much lighter and airier than the blue-gray color that was there before and while I was a little worried – as always – that I wouldn’t like the colors, I love them.  I had wondered if my “anti-accent” wall would be too much (and thus should paint the whole basement in the sea-glass) or if the three colored walls would feel oppressive (and thus should paint everything cream) but the balance turned out nicely.
  • Now we’re on to the basement steps, which involves sanding the rough lumber that’s there. I’m pretty sure these were originally carpet-covered, but for some reason the carpet was removed and a dark blue paint slapped down. Not great looking and, because I have some sensory issues, I hated the texture on my feet.  The trick now is to sand enough to make them feel decent underfoot but not so much that the paint doesn’t stick.  We bought stair paint in the same cream and sea-glass green as the rest of the basement.  The steps themselves will get the cream, while the risers will be sea-glass.  Then we’ll throw some thin microfiber treads on the main part of the steps.  Hopefully it will look good (at least better) once it’s done.
  • I read Ariel Levy’s memoir The Rules Do Not Apply and Sarah DeGregorio’s Early: An Intimate History of Premature Birth and What it Teaches Us About Being Human. Both made me tear up for different reasons, both were excellent, and I’m hoping to delve into these with a more in-depth review here soon! (Content note – Levy’s memoir involves a stillbirth and DeGregorio’s also delves into neonatal loss.)
  • Started the paperwork to register E for kindergarten. This is awesome and honestly, pretty emotional.  Kindergarten was the thing I used to hang onto in the hospital and the NICU and as we went to specialist appointments and PT/OT/ST sessions, as in “someday, she’s going to be in kindergarten, we are going to make it…somehow”.  I’d picture her getting ready for her first day, beyond the terror that a simple cold would kill her, beyond the bradycardia episodes, and the monitors.  I really cannot believe we’re now so close.
  • Managed to finish a project for work on condensing some “good points” from continuing education course I did for the rest of my unit. It’s not a huge thing, but I’m really pleased with how it turned out.
  • Confessed to my choir director some long-term and (to me) embarrassing deficiencies in my music reading abilities. He was totally non-judgmental and basically told me that if we don’t admit what we don’t know, we never learn.  I’ve been meeting with him to remedy those and I’m excited because I’m actually learning how to do some of these things now!
  • Because we bit the bullet and went for the Dis.ney+ subscription service, Arthur and I decided to start watching the Marvel/Avengers movies as it feels like a lot of people talk about these. Have now seen “Captain America”.

What are you up to these days?

This post is a part of Microblog Mondays.  If you want to read more or participate yourself, head on over to Stirrup Queens!  Thanks to Mel for originating and hosting.  

“And”

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Content note: pregnancy, children, loss – none recent

This weekend, we tore up some of the scrotty grass that’s never grown well next to our patio in the back and put in hostas.  I pulled out the dead hydrangeas from the back bed and planted shade loving coral bells.  We went to visit college friends and as we sat, I had one of those moments that might be called transcendent or even holy, where for just a second, everything was right with the world and good.

The new life, both literal and figurative, was all around us.

I came home, checked my calendar, and realized that it’s not all that much longer until my saline infusion sonogram for this final transfer.  And before I knew it, this morning I was ugly crying, the one that isn’t a couple of crystal tears decorously sliding down the cheeks, but the red-faced, sobbing, snotty Kleenex filled kind.

That’s life, though, isn’t it?  At least after a certain point?  Where the most extraordinary exists among the prosaic of every day and the deepest, darkest muck that can be dragged up?

I am so incredibly, amazingly thankful for my girls.  And I am so terribly sad that I never got to meet the three that died and were miscarried early, long before they truly lived.

I honor the truly ordinary, uneventful pregnancy I got the immense privilege of experiencing.  And I grieve the long weeks of waiting, of fertility treatments and IVF, of hope mingled with sadness, of ultimately having three others over far too early.

I get the loveliness of watching my older daughter survive and now thrive.  And I mourn that she lost the last weeks in pregnancy that she should have had, that she went through so many painful procedures, that we were separated by plexiglass walls and nights apart at the beginning of her life.

I can’t even express how much gratitude I have to see the girls treasuring each other and also fighting – as siblings do.  And I can feel my heart breaking again and again and again that my sibling is gone, that a person I held as he came into the world left it long before me in such a terrible, senseless way.

I hold my dear ones close, their precious selves tangible and messy and wonderful and alive.  And I cry remembering the unnatural coldness of my brother’s still face, the benediction of viewing him in death, the slight smear of blood that transferred to my hand when I put it on his cheek.

I am fiercely glad for my marriage and the love my husband and I get to share every day.  And I mourn the things we have both broken over the years, some of which are still being repaired.

I am grateful for the chance to complete this final cycle, to close out this particular road, to know that no matter the outcome, I am truly fortunate and ready to live this good life I have.  And I am anxious, struggling with the months of waiting in the lead-up, dreading some painful procedures, and worried about the potential for more hurt.

For the last several months, I’ve been veering back and forth between the extremes, saying how I’m fine (true) and FINE – F*cked Up, Insecure, Neurotic, and Egotistical * – (also true).   It doesn’t sum up neatly, the pros and cons on the paper don’t cancel each other out.  They’re all true, all a part of what poet Mary Oliver termed “your one wild and precious life”.

I am, without a doubt, in today’s parlance, a hot mess these days.

And…it’s an absolutely beautiful mess as well.

*credit to Louise Penny

This post is a part of Microblog Monday.  If you want to read more or add your own, please head over to Stirrup Queens’ blog.  Thanks to Mel for originating and hosting.  

Those Ads

Reading the other day, I came across this article on Slate about ad algorithms, grief, and social media (TW for stillbirth).  Basically, it explores the phenomenon where, post loss, people are still bombarded with ads for baby or pregnancy items when they go online.  It also has the FB shortcut to hide some of these ads but less advice about the vexing problem of FB’s tendency to “celebrate” anniversaries of particular posts.

When it happened to me, I was pretty sure I wasn’t the only one who had it occurring.  I can vividly remember getting baby ads after my first miscarriage because I’d spent time looking up pregnancy-related websites.  It sucked, especially in those first few days after arriving home from the hospital post D&C when I was physically and emotionally achy.

My second loss was a little less problematic in terms of the ads – mostly because I had known something was wrong from the start and my searching had been confined to things like “ectopic pregnancy symptoms” and “really low beta HcG” and “pregnant but bleeding”.

The one that really wrecked me, however, was after E’s birth at 28w4d when I kept getting ads for maternity clothes while she was in the NICU.

The Slate article goes on to talk about why there aren’t better algorithms to prevent these triggering ads: “The real problem is that there’s no quick capitalistic incentive for Face.book to do the work of sorting ads or pictures for you.  As one grieving woman told the Australian website…’There’s no money in miscarriages, obviously.’”

Having walked through infertility and miscarriage, I can’t help but think, as do the women featured in the article, that there really does have to be a better way.

Preemie Parenting: Our Own Version of Normal

Like a number of preemie parents I’ve read, I figured once we got E home from the hospital – especially the second time, when she was off the oxygen – we’d eventually pick up a somewhat regular infant experience. I mean, I understood that she would be developmentally closer to her adjusted age and there were going to be challenges, but after NICU, being home felt luxuriously normal.

When E was in NICU, twice nurses referred to her as a “micro-preemie”. I bristled a bit at that, and technically speaking, I was right: micro-preemies are usually considered babies born 26 weeks’ gestation or less and under 1.75 pounds. However, it’s not unusual to loosen the definition to include babies less than 29 weeks’ gestation and/or under 3 pounds, which E fits on both counts. Regardless, I didn’t want to hear it. E was a miracle. She had never needed a ventilator and was on c-pap for around 24 hours. She was going to be completely fine, and by ‘fine’, I mean that somewhere in my head I got wildly optimistic and figured that things were going to get much closer to what one would expect with a term baby.

Well, E is still a miracle, and I don’t use that term lightly. She smiles, giggles, and loves people.  She reaches for toys and plays now.  There’s no doubt we beat the odds big-time with her surviving at all. But despite the fact that E is doing remarkably well for how premature she was, there’s also no doubt that it’s not quite the same thing as raising most full-term infants. We go to doctor’s appointments/tests about once a week and get therapy weekly right now.

I got my first major taste of this beginning in August when E decided she was not going to eat peacefully. Prior to this, E had started occupational therapy (OT) to help her keep up and reach developmental milestones, which I had expected she might need. Eating had always been a challenge, but starting around the middle of August, the struggle intensified dramatically. When I say she wouldn’t eat, I mean she kicked, screamed, arched her little back and tried to throw herself off my lap to get away from the hated bottle.

In my drafts, there are writings totaling over six pages detailing the many visits with the pediatrician, specialists, Zan.tac, Pri.losec, changing bottles, changing techniques, and Arthur and I staring at each other in total frustration and worry as we watched our normally happy baby turn into a child that alternated between lethargy and screaming. It came to a head in mid-October when the GI specialist nearly admitted E back to the hospital but told us we could try a hypoallergenic formula as a last-ditch effort to avoid readmission. If she didn’t improve quickly, we had very little choice.

The new formula worked. E improved and was diagnosed with a milk allergy. She did not, however, get enormously easier to feed. Somehow, probably because Arthur and I are nothing if not incredibly stubborn, E has managed to gain weight and avoid a ‘failure to thrive’ diagnosis. We track every calorie. The ongoing battles with feeding continue to be a challenge.

Around this time, I also noticed something else. E has always had a few very mild contractures on her left side. We – and the various therapists that saw E both in NICU and First Steps – always assumed that the reason for these was the PPROM and being trapped for weeks in one position without amniotic fluid. The problem was that as E grew, they weren’t going away. She developed a bit of torticollis that led to a decided flat spot (plagiocephaly) on the left side of her head. With the OT and a lot of stretching, we managed to get the torticollis mostly corrected and the plagiocephaly improved.

During tummy time I also started to notice that she would push up with her right arm, but not nearly as much with her left. I pointed this out to the OT who assessed E and agreed. The left arm and leg were weaker than the right. We continued with OT and waited a little longer. The left sided weakness was mild, but continued to persist.

The weakness and contractures that were decidedly one-sided (hemiplegia) stood out as a possible neurological issue. I knew neither of E’s two brain ultrasounds in NICU had shown bleeding, but I also knew that the weakness was still present. I asked the doctor at the neonatal follow-up clinic about it, and she concurred that possibly having a neurologist evaluate was a good idea. We waited another month for the appointment, hoping E might continue to grow out of it and the appointment would become unnecessary.

The appointment was necessary and the neurologist agreed that there was a tone difference between the right and left sides. “I’d like her to have an MRI,” the neurologist told us. “She may have a small lesion in her brain and some mild cerebral palsy.” Seeing the alarmed expressions on our faces, the neurologist explained that cerebral palsy simply means that something happened that affected E’s motor skills before age 1 and reassured us that it didn’t mean that she’d never walk or have severe motor issues. In fact, the neurologist said, she expected E to keep progressing well and eventually catch up. She pointed out that E uses her left hand and it wasn’t contractured into a fist, which meant whatever is going on is very mild.  The neurologist also told us that the MRI might look normal and the issue might be due to the PPROM and restricted movement.

The neurologist also told us E needed a swallow study because of the hemiplegia. I’d refused swallow studies in the past because everyone had told me that the study checked for aspiration and we knew E wasn’t aspirating. She didn’t have the lung infections that mark even silent aspiration and no other symptoms. However, this was the fourth or fifth medical professional that had recommended a swallow study, so I reluctantly agreed and the swallow study is scheduled next week.

The MRI is scheduled for tomorrow. There’s a sense in which nothing will change, no matter what it shows. We think E is wonderful. She’ll continue with therapy. Regardless of the challenges, diagnoses, or issues we face going forward, what matters is that she’s our daughter.  We’ll love her, parent her, and fight for her, just as we always have.

What it does remind me, however, is that E isn’t a full-term baby. That this didn’t end when we left the hospital or got rid of the oxygen or finally turned in her apnea monitor. It’s meant that I finally have to start letting go of those things that define other people’s parenting experiences and embracing E’s timetable and coming to terms with accepting that E was born at 28 weeks due to circumstances beyond our control and all that entails.

It is what it is.  And that’s okay.  It’s our own version of normal.

48 Hours (Part 2)

Part 1 and Explanation/Disclaimer

“The ultrasound just showed that you have a subchorionic hematoma,” the nurse informed us when she reappeared about an hour later. “The amniotic fluid level was within normal limits, and I know you said you’ve had the SCH for quite awhile. The doctor said he still wants you to stay until he can actually check you over when he comes in, so let’s get you to a room where you can get a little bit of sleep.”

The nurse led us to a room across the hall. I was so relieved that based on the ultrasound clearly my amniotic fluid levels were normal and so tired that I barely registered the fact that I was being placed in a labor room. On my prior visits, I’d been in rooms all the way at the postpartum end of the hall. It’s a detail that stands out now for its significance, but denial had kicked back in and I happily made myself comfortable in the bed while Arthur stretched out on the couch.

The next several hours passed fitfully with the periodic rushes of fluid waking me over and over. Finally, at around 5:30 am, I stood up to go to the bathroom and change the soaker, turned on the light, and stared as deep crimson drips rolled down my thighs. I called for the nurse immediately, handing her the now blood-soaked cloth. The room was still darkened, but I briefly saw her expression change, then: “We’ll make sure we put this by the sink for the doctor to see. He should be in soon.”

“This is just the SCH, right?” I asked, desperately needing to hear that nothing was really wrong, not really. “I mean, I’ve had lots of bleeding throughout this pregnancy.”

“I don’t know,” the nurse said gently. “We’re going to have to see what the doctor says. Let me know if you have another pad like this. I’ll tell him he needs to come see you as soon as he gets here.”

“Are you okay?” Arthur mumbled from the couch as I climbed back into my bed.

“I think you need to cancel your doctor’s appointment as soon as the office opens,” I told him. “I don’t know what’s going on. I think it’s the stupid SCH acting up again. I can’t believe this. I thought it was done when all my clots came out a couple of weeks ago. And now it’s going to ruin the nice day we had planned. Maybe we can still do my bump shot when we go home.”

I lay silently, willing the ominous flow to stop, pleading with God to make it stop, to let my baby be okay, please. Please let the doctor get here. Please let it be something that he can fix. Please let this not be a big deal. Over and over and over I repeated this as though repetition might somehow bring it into being. Please.

I must have fallen asleep at some point as a brisk knock startled me and the nurse peered around the door to tell us that the doctor was reviewing my chart and would come in shortly. I sat up, blinking against the sudden influx of light, then carefully peeling the cloth pad between my legs away to check. Still bright red, still trickling out. I didn’t have time to consider what this meant, however, as I heard another knock and the doctor walked in. I held up my pad for him mutely.

“Hmm,” he said noncommittally as I proceeded to tell him what had happened and gestured to the laundry bag full of saturated pads and soiled sheets, showed him the pad by the sink. “Well, I think I’m going to go call the perinatologist. I’d like his opinion before we make any decisions.”

He left and I started crying almost uncontrollably. Something about the care with which he’d chosen his words terrified me. It confirmed what I already knew somewhere deep down: something was horrifically wrong. “If this is it…” I began, trying to get out words that I couldn’t grasp, couldn’t say but knew I needed to convey somehow to Arthur, “If this is it…oh God, how are we going to get through this?”

“Let’s wait until the doctor gets back,” Arthur said soothingly. “He just needs to talk to the specialist.” Realizing that Arthur still genuinely thought it was going to be okay, I pushed down my fear, stopped crying. Maybe I was overreacting.

The doctor returned. “I think we’re going to send you on to a bigger hospital,” he told me. “There’s nothing we can do for you here. Unless…” He paused. My eyes landed on the warmer in the corner, draped with blankets, awaiting a new arrival and suddenly I felt sick. My baby could be born today. And if that happens…no. No.

“Okay, so how would that work? Would we just drive there?”

“I think an ambulance would be best,” the doctor said gently. “I’ll just make a few phone calls.” He stepped out again, and again, I found myself on the brink of panic. I knew something that Arthur didn’t: the criteria for ambulance usage. If the doctor thought I needed to transfer by ambulance, it meant that he felt there was a significant risk that I would either hemorrhage dangerously or go into labor during the hour-long journey.

“I’m going to call my parents,” Arthur said. “They need to know where we’re going.”

“Yeah,” I agreed. “I’d better call mine too. Do you really think I need to go by ambulance? I mean, I think it would be okay if you drove me.” Denial slipped down around me, comforting and thick. I made a quick call to my mother’s cell, got her voicemail and left a message telling her to call me back.

The doctor came back one more time to let me know that the transfer was all set. “The north hospital is full, so we’re going to send you down to City South Hospital. You work there, right?” I confirmed this was correct, and he nodded. “Dr. H is admitting, and then the perinatologist will be in to see you once you arrive.”

“I know Dr. H,” I told him. “I think that sounds good.” Arthur agreed.

Before the doctor left the room, he noticed the NFL sweatshirt Arthur was wearing. We had a surreal conversation about Tom Brady’s deflated footballs and the upcoming Superbowl and whether or not the Colts really had gotten screwed in the playoffs. As the doctor headed out, my phone rang: my mother. “Something happened. They want me to go by ambulance to the city. I’ve been gushing fluid all night and now I’m bleeding again. I don’t think I need to go by ambulance, it’ll be expensive and I’ll be fine.” The nurse was back in the room now, IV supplies in her hand. I nodded at her that it was okay if she started looking for a vein and switched the phone to my other hand.

My mother spent most of the conversation talking me into going in the ambulance while the nurse – much to everyone’s surprise, I’m generally a tough stick – got my IV in on the first go. “I’m calling EMS,” the nurse said as I hung up the phone. “I don’t know how long it will take for them to come, but I’ll let you know when I find out.”

Meanwhile, Arthur had managed to get in touch with his mother, who, sensing something was awry, asked him if it would be okay if she left work and met us at City South Hospital. “Yes, I think that would be a good idea,” I said, surprised to hear the words. Surely nothing was that wrong to necessitate hurrying out of work.

“Plan to meet us there” said Arthur as he hung up.

“Since you can’t ride in the ambulance with me, I think you should go home and get some stuff. I want you to grab my kindle, maybe the ipad. Also some clothes. And…” I trailed off. “And can you find a shirt or something that looks okay? Like nice enough for photos? Just…just in case? Like one of my wrap sweaters that will still fit right now?” Tears ran down my face. “Why don’t you get a shower too? It will be a few minutes before EMS gets here and you know how this works. It’s a lot of ‘hurry up and wait’. Even if you get to the city a bit after me, it’ll still be awhile before the doctors come see us. You may as well clean up.”

Arthur agreed and stood up just as the nurse walked in to inform us that EMS would arrive within the next half-hour. He bent over, kissed me and was gone.

The next twenty minutes felt incredibly long. By myself, no need to put on a good face for Arthur, I found myself sobbing and sobbing. The achiness in my belly intensified. A horrible thought emerged: what if this is the beginning of labor? No. NO. I called the nurse. “I need something for pain, please. Now.”

“What kind of pain are you having?”

“I just feel achy. Crampy, really.”

Her face registered concern. I have no doubt that she knew what was most likely happening, but she simply told me very calmly “I’ll find out from the doctor what you can have, and we’ll get you something.”

Everything happened at once. The paramedics came in, bearing a stretcher and equipment bags. The nurse came back with the pain medicine. It all felt wholly unreal to me, as though I was watching from some great distance, not living the experience. I scooted over to the stretcher. The buckles of the safety belts clicked into place, the stretcher lifted as the paramedics prepared to wheel me out. The nurse injected the pain medicine into my IV. “This is Sta.dol,” she informed me. “Hopefully it will help.”

I remember how she patted my arm. “Good luck,” she whispered. “I hope it is nothing and we see you back here in May or June.” Then she was gone and the paramedics were wheeling me down the halls, through the emergency room into the cold, grey January morning. I shivered as they loaded me into the back of the ambulance.