The long, slow exhale

The rest of my life--the slim portion that doesn't revolve exclusively around my pregnancy--is plugging along at a tiring pace. But, then, everything is tiring at this point; I've even started taking elevators up a single flight of easy, wide stairs, which embarrasses me no end but is better than the heartracing and wooziness that any exertion brings about. I am told that this will pass one day, and just hope that day gets itself here in a quick hurry.

Work is hectic and frustrating and full of unmakeable deadlines, but is also better than before because my sweet, sweet Jeff is there with me every day, plugging away at the same mind-numbing projects. (Yes, we spend every minute of every day together. And we like it. Shut up.)

Tomorrow morning, we rent a van and drive to the City of Angels to pack up my grandmother's house. It will be a lot of work, but I will rest easier when it is done. And that sweet, sweet Jeff (have I overdone it with the "sweets"? Are you nauseated? I will stop) has found a way to fit Nam's brocade couch into the if-all-goes-well future nursery, where he has a vision of reclining on its burnt umber softness while the tiny Devo lies supine on his chest. This picture makes me want to cry, in a sloppy-happy-pregnant sort of way.

Two astonishing things today: 1) I saw a doctor who was not an R.E., and 2) I had an ultrasound for which I did not have to strip my skivvies. Hard to credit, but it's true. And, to my vast relief, there's still a living fetus in there, and his head, at any rate, has finally caught up: he measured 13 weeks 0 days; I am at 13 weeks 0 days.

I think this is the point where I may start to exhale. Tentatively, of course, and very, very slowly, but I think I might just try it nonetheless.

Devo

That last week has been a muddy, foggy blur of driving, mourning, working, driving, cleaning, driving, crying, driving and relief.

Jeff and I hosted my grandmother's memorial gathering at her house in the Southland, cleaning up the dust left by months of disuse and the strange greasy scum that settled over her belongings. Her plants appear to have died around the same time she did, though it's likely due to my father forgetting to water them and not some cosmic connection.

At the memorial, the old man talked incessantly and without my prior authorization to all comers about my "happy situation". Elderly ladies patted my slightly protuberant belly and told me of their own pregnancies, way back in the day. There was the woman whose three daughters were born in successive years on April 2, April 3 and April 4, and whose son was a month out of synch the next year, arriving May 5. I smiled and admired her fortitude and resiliency in managing four children under five. (She said it was nothing--"Of course, we didn't work back then." Not work. Funny. With the energy required by my job, I could care for about one tenth of a baby, even now with the twelve hour days, or perhaps power a low-wattage, eco-friendly lightbulb.

It felt unspeakably odd to be the object of congratulations from people who knew nothing of our situation, especially as I was sitting there with a small pit of dread building in anticipation of today's twelve-week ultrasound. I had to stop myself from adding "if we make it that far" when asked my due date.

But the pit of dread was for naught. The scan today was a good one; the first unequivocally good scan since we started. He* is growing well, though still behind by a few days. He has a fairly strong heartbeat. He has hands, and legs and teeth--teeth!?

As we watched the monitor, the IVF Coordinator made little peeping and oohing and squeaking sounds; she'd never seen one this big, since they usually turn over their pregnant patients to OBs at eight weeks. The stoical Dr. Meow smiled as he moved the focus and pointed out the bits and pieces--the umbilical cord, the feet, the ears, the jaw--and even grinned when the little guy did a full-body jerk. Which he then repeated, rhythmically but spasmodically, a la "We Are Devo".

And since it's about time we started to call him something other than "the lump" or "the little guy", I think that's what we'll use: Devo.

Whip it good, my young fellow.


*No, we do not yet know the sex. He just seems boy-like to me so we've settled on "he" for the time being.

Not there yet

I have a dozen self-pitying posts that keep trying to come up, like bile, but the thought of putting them out leaves an acrid taste in my mouth.

There is nothing new to say. I have no reason to assume that something has gone wrong with the one that remains, even if my anxiety swells tangibly day by day. I'm counting on the promise of time to bring some semblance of equanimity.

Do you think it works that way--time, I mean?

No decision to be made

A second tiny spot of brown gave me the first ambiguous indication, just this morning, before the 11:30 ultrasound.

Two of the fetuses gave up. They are there, clearly visible, but their heartbeats are gone. I am numb and sad and fearful in alternating measures. How long will this adjustment take, the giving up of my imagined three? When will I be able to embrace and cherish the fact that I still have one, even if that one now seems even more precarious?

But that one--that one was something to see. All four limbs were dancing and waving, there were somersaults and twists, a bundle of motion. I want to remember that extraordinary moment untainted, but, to be honest, I was focused even then on descrying some sign of life in the other two sacs, which looked smaller and static. A minute later, the doctor trained his wand more carefully on them and confirmed what my untrained eyes could already see: no movement, no heartbeat.

I know that there are advantages. I know that I should appreciate not having to make the horrible decision. But I want them back.

Cold

Soon after my last post, the phone rang. It was the maternal-fetal medicine doctor, who had been roused to action by a prodding from Dr. FYC.

I was taken aback by his tone: no preliminaries, no questions of me except my age, height and weight. When he went into his spiel, it sounded as though he had delivered the same lines a thousand times.

Full pregnancy loss for triplets between 12-24 weeks: 10-15%.
Post-delivery mortality rate per triplet: 15-20%.
Full pregnancy loss after reduction of triplets to twins: 3-5%.
Post-delivery mortality rate per twin: 5-7%.

My advantages as a potential high-order multiple mother are not insignificant--sedentary, low-stress job; the ability to go on extended bedrest without bankruptcy; generally good health; a willingness to do whatever it would take--but the disadvantages are blunter, perhaps more meaningful, and out of my control: I'm just over 5'4" and went into this pregnancy at 118 pounds. That's three inches and thirty pounds shy of his recommended cutoffs, and there's not a damned thing I can do about it.

I will find another expert and another opinion. These numbers seem so high; I don't know if I trust them. But now they're out there, tangible, coloring my imaginings of the months to come.

This decision is breaking me up in a hundred small, warring pieces. I want it to be over.

...

My grandmother died this morning in her sleep, just before four a.m. Pneumonia appears to be the cause, though her chronic heart failure was likely the root problem. She suffered another series of small strokes not long ago, and had fallen into a semi-conscious state from which she struggled to rouse herself each day when my father arrived. She was uncomfortable, couldn't see much and couldn't hear well, but did not complain. She would turn all conversations about herself and how she was feeling to us--what we were doing, how we were doing, what our plans were. She gave congratulations for our successes and sympathy for our minor annoyances. She was so pleased about the pregnancy; it was something she had always wanted for me, long before I wanted it for myself. She loved Jeff as a grandson and told me often how lucky we were to have found each other. She kept talking, even when the strokes had made most of her words impossible to understand, and somehow made herself clear. She had her faculties, and even her sense of humor, through it all.

There will be no funeral--my father is not up to it--and she will be buried next to my grandfather without fanfare. We will meet at her house one day soon and remember her in the place and with the things that have come to represent her to us all. We will picture her sitting on the tasteful brocade sofa under the Thai temple rubbing, slender stockinged ankles crossed demurely, listening and encouraging.

It was time for her to go; that much was very clear. There is a certain relief. But I will miss her now and mourn the loss, and I will remember her always.

Hurdles

We were referred to a maternal and fetal medicine specialist, one who has an excellent reputation both for successfully shepherding high-order multiples into the world and for his skills in selective reduction. We were pleased and thought optimistically that we might meet him this week, begin to form some sort of plan.

However, the simple act of calling for an appointment has been an unimagined obstacle; I tried several times from work, sneaking to my car and clutching my cell phone in desperation as a ten minute hold became a twenty minute hold that turned into a disconnect. So Jeff tried a half-dozen times, as he was home, and finally managed to reach a receptionist on Monday. With incomparable incompetence, she insisted that Jeff was mistaken and that I was only at six weeks' gestation (it was nine weeks on Wednesday) and said that "the doctor is not available for regular appointments but will call you for a phone consult within the next six weeks." Seriously, that was her answer.

Dr. FYC is contacting his office to see what can be done. In the meanwhile, I am trying to focus on eating and functioning and working and eating and trying not to wonder what the future will hold and eating some more. I do not want to eat--want nothing less, in fact--but have read enough about how important weight gain is with multiples to feel compelled to try. The book that several of you recommended--"When You're Expecting Twins, Triplets or Quads" by Dr. Barbara Luke--is both fascinating and daunting: How on earth will I gain eighteen pounds by week twelve while battling constant nausea?

After trying to follow a fairly healthy diet for the last twenty years, I'm now admonished to start snarfing platters of steak and pork chops, pounds of lasagna, mountains of mashed potatoes, tubs of ice cream, butter and hamburgers, Egg McMuffins and Hostess Fruit Pies, and all without being able to enjoy them one single bit. The thought just makes me want to cry. And puke.

I just don't think I can manage it. And I didn't realize that feeling like an inadequate mother could crop up this early.