Barely tenured

Appropriate units of measurement

Height of stack of remaining grading: inches.

Dilation: centimeters.

Time until grades are due: days.

Time until birth: days (I hope).

Folks: don't try this at home, no matter how much you'd like to really max out your institution's parental leave policy.

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I do feel a bit of (survivor's?) guilt with respect to how it all looks to outside observers, most especially junior female ones. Look, I wasn't trying to do this. Really.

It's on my list to update here

So, past midnight, let me tell you: I am well.

Huge. Intimidated by the new semester. Snowed in. Craving chocolate and vegetable puree soups.

Nesting like crazy. (When a pregnant woman asks for a label machine for Christmas? Worry.)

I had my 20-week ultrasound just before Christmas. All is well; the wee beastie is a little on the small side (which may bode well for my making it through finals), and appears to be another girl. Yay!

P.S. I want a Kindle! For nursing, y'know! And this made me feel really bad about kind of wanting one of these, even though I've gotten my by-now-quintuply-used Pump-In-Style Advanced back, and even though I'm going to have, effectively, the longest maternity leave ever -- like, nearly 8 months.

Picking at scabs

I have a terrible problem with scratching open mosquito bites until they bleed. I also chew either nails or cuticles -- one or the other, typically, for months. My nails are grooved from the cumulative damage.

(Miss T. already is getting hangnails -- perhaps there is some built-in tendency for the skin to split, especially on the thumbs -- and she chews on them. I don't know if she's seen me do it, or if it's just the obvious thing to do. I can't bring myself to criticize her for it, so I offer sympathy when she complains, trim down what I can, and try to get thick lotion on them before bed.)

 

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Now, I'm reading the comments to the big Alex Kuczynski piece on the birth of her child through surrogacy. The editors certainly stirred the pot through their choice of photographs! and the author is as honest about her classism (and that of the surrogacy "industry" -- they don't want surrogates who are, you, know, actually poor) as she is about her grief and later her joy.

(How different would reading getupgrrl have been, if there had been pictures? She was so careful in the details she chose to include.)

On the one hand: we spent our money and took our chances for exactly the same sorts of selfish reasons: to have a child who is genetically Beaker's. And there are a lot of (mostly appalling ignorant) people over at the Times who are saying "SCREW YOU, SELFISH BITCH!"

On the other hand: every time I sat in that Cornell waiting room (where Kuczynski starts her journey) I knew I didn't fit --  we could only fake it enough to be there by living off two incomes in a cheap damn state. So each comment that picks up another detail of the outrageous presumption of privilege tickles a little -- and I keep reading.
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During our peaceful Thanksgiving dinner at home, there was a blizzard of kicks.

Since then, nearly none -- and definitely none so distinctively kick-y. I know it's still early, but I can't help panicking. Were those death throes? It's so easy to slip back to the disoriented sadness of October.

Eleven days until my next midife appointment. I'd rent a Doppler, but if I didn't find a heartbeat it would kill me.

Maybe -- presuming it goes well -- I'll get one after the next appointment.

14 weeks

I'm here. It's still here. Nuchal scan was entirely normal; ultrascreen came back with 1/4000 chance of Down's, 1/2000 of trisomy 13/18.

I keep saying I'm trying to decide whether to get an amnio or not. But then I keep not calling to make an appointment to talk to someone appropriate, and the weeks are slipping away.

I don't want one.

Even though I have at least 3 good reasons for getting one: my age, my R.E.'s recommendation that all ICSI pregnancies get one, and that damn 7 week ultrasound.
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After the nuchal I started telling people (not like my belly wasn't already doing the talking for me!). Applied for my maternty leave -- yes, this early, so that my poor department has a chance of replacing me.

We told Miss T. last weekend. She doesn't seem to care much, yet. That seems fine.
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There is still not much joy.

My exhaustion has burned out, thank goodness.

But Beaker is sick, coughing and short of breath, and has not been getting better, and we don't know why (not specifically -- of course we know it's lung inflammation, but from what source and for how long?) -- and that's deeply frightening, in context, for both of us.

We will probably not go to Weatherwood for Thanksgiving -- long drives are a known strain for him. Marina's daughter will be there, along with several friends, and Marina called a few days ago to make sure we wouldn't be getting in the way too much -- well, more delicately than that, of course.

Needing sleep

I am still pregnant. So far as I know. Another ultrasound, nominally for nuchal translucency purposes, in a week.

Cornell told me to start tapering off the PIO after the 9w1d ultrasound, but wanted a level check before I went off entirely. I went in live (well, to Mount Kisco at least), since I was in New York anyway. Came back at only 16, but they told me to stop. I did.

I am having a lot of trouble keeping up with life. Midterms! Advisees! Recommendations! I am too tired to knit, or to read anything more taxing than Agatha Christie or Talking Points Memo. I'm getting a lot of mild migraines, which I didn't at all last time. With each one I wonder if there's been a sudden homone drop.

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I had trouble keeping up with life when I went back to Weatherwood, too. No panic attack on the Whitestone Bridge (last time I drove myself over it was... well, it was 11 years ago, and that's a whole 'nother entry)! But I didn't even start to cope with replacing the marker (the fucking cemetery needs two rounds of notarized correspondence, from my uncle, not me, before we can do anything) or with tracking down a moving company for the furniture that's coming back to Ohiodinois. Nor have I made much progress on figuring out what I owe my uncle, after all.

I did get him up to the right county office for the paperwork to get into Nana's tiny bank account. And I packed up, or brought to professionals, a lot of small objects. We brought in an appraiser; nothing is worth anything, of course. (All the furniture, all the things on the walls, had been Nana's mother's -- they came to New York from Ohiodinois in 1954.)

So: I'm giving Ricky $1000 a month for a year, nominally for six or seven pieces of furniture I want (the will leaves all "tangible" property to me -- and the funeral expenses, which I paid, can be taken out of the estate -- and the cash is about three times the value of the pieces, which are both unfashionably dark and heavy and in poor condition -- so legally, legalistically, I really don't owe him a fucking thing), but mostly because I can't see any way for them to stay in the apartment long-term. I tell myself it's to help make the transition out easier -- or at least a bit later and more predictable. I worry that he'll think that this is setting some kind of precedent. But I want to feel like I've done enough for them that I can say "no" next time with a clear conscience.

There's a china cabinet that I want, that Beaker loves, that Marina says my grandmother told her she should get. There's no way to know if that's true; my uncle had thought my grandmother meant one set of dishes in the cabinet. There's an edge of true bitterness as Marina talks about it. I don't want to make her truly bitter. I am leaning towards letting her keep it -- so that I can say "no" when I need to.

The will leaves Ricky all family pictures and records. Does he give a flying fuck? It's hard to tell. They are still in deep grief. Marina told me to take two oil portraits -- both ripped -- because "your uncle will never have any children, but you, you have a legacy."

I went through what papers I could find, photocopied a bunch of birth certificates and old newspaper clippings, and scanned in about a third of the photographs from the only remaining album. I'll do more at Thanksgiving.
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Am I sad? Yes. But it is hard for me to catch myself at it. It is going to take time to sink in. There is too much. My mother's death was, in many senses, a liberation. But Nana? It was her time, God knows -- but she carried so much more with her. And that's gone for me now.

We took Miss T. apple picking that Saturday, the weekend I didn't go to New York. The light in the orchard was exquisite. It's really hard to get pictures of Miss T. smiling, but I did -- and there are also several gorgeous ones of her pensive, with luminous gray eyes focused out of the frame. Nana would have loved them.

This and this made me cry. There are just a lot of parallels, even dumb little ones -- like going back to an apartment his grandmother has been in for decades.

So did this. I go over and over my two final decisions to stay. I didn't know how sick she'd gotten on Friday night. I didn't talk to Ricky between Friday afternoon and Tuesday morning. Then I didn't drop everything and fly out on Tuesday because by the time he called, the doctors said she'd be dead in a couple of hours -- no time. But she hung on for another day -- but I wasn't there.
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This is one of the first pictures I scanned:

My grandmother and me, in the yard at the House, presumably in the winter of 1970-71. Notice that it's been torn in half, right between the two of us, then taped back together. There were several like that.

I'm guessing that my mother tore them up, and my grandmother saved the pieces.

Normal

The ultrasound today was normal. Normal growth, normal placement, normal gestational sac, etc. -- and a normal heartbeat pounding away 182 times a minute.

I went straight to my first midwife appointment afterwards.

I am going to lie down for a little while now.

Random bullets of desperation (except without the bullets)

My grandmother died on Wednesday morning, as I was traveling.

Beaker drove out on Friday with Miss T. We held the funeral mass on Saturday.

Everyone who came to the wake was either a neighbor (they all cried) or an old, old, old as in high school, friend of Ricky's.

I am very frustrated by my uncle.

So is Marina. She, however, is married to him. I give it less than a year; she's someone who falls on her feet.

They're going to try to keep the apartment. I give that less than a year, too.

There's a will. It's exactly as hellish as you might expect from my family, particularly since there is no money -- which is all that Ricky wants -- and the only thing I want, namely family pictures, records, and memorabilia, goes to Ricky. He's executor, too. Oh my God.

I'll go back out next week to try to put things in order. Ha.
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It is easy to make excuses for why I was not closer to my grandmother. She was a very difficult person; she held herself back from everyone, emotionally and physically, and she could lash out viciously with little provocation.

For the last seven years, Ricky was living with her, and I found it very difficult to visit -- both because of his presence, and because of how they played off the worst in each other.

But I let that gap grow.

Ricky's high school friends remember me as a toddler running around the House (the one lost in my grandfather's bankruptcy); my grandmother took care of me then. I don't know if my mother was even around much. In her papers I found a couple of poems that seemed to have been written after she'd been caring for me as an infant, and then my mother took me back (one time that ended up with me with pneumonia, my mother back in the hospital). I remember so little of those years -- but my grandmother was the one, I think, the one who was there when I was small.

But after I was taken away from her over and over again -- by my mother, repeatedly, by my foster father trying to keep me, by the custody fight, by my growing up and moving into a wider world -- she was too hurt to let me in again. And I didn't fight it.

The only reason I saw her so often this past year is the IVF cycles. I didn't even go for Thanksgiving last year --- we were going to have a big dinner in January to make up for it --- and then the January cycle sucked and I got depressed and Beaker and Miss T. never came out to New York.
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Ricky seems to believe that my family and I will continue to visit regularly.

On the one hand: what the FUCK?

On the other hand: they all hated each other for years, and what good did it do? Why should I carry on the tradition? (Plus, he could be a really effective anti-drug message, just being his lovely self.)
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I am nominally nine weeks pregnant today. I feel and look pregnant. Nausea, huge sore breasts, a belly that's moderate in the mornings but balloons out through the day. Inability to concentrate. Fatigue. All just like last time at this stage.

It is killing me that it is all, almost certainly, meaningless -- the hormonal effects and physical displacements of a hard-working placenta, doing its best to support something fatally flawed. I can never really believe during the 2ww that the symptoms are meaningless -- but this is multiplied a thousandfold.

Tomorrow I go for my first ultrasound since seven weeks -- that was the bad one. Beaker is driving me, because I can't imagine getting myself home if the news is what we have to try to expect.

Redoubled vigil

At the end of Monday, things didn't seem too bad, all in all. I'd gotten through my grading. As long as I managed to scrape together two midterm exams on Tuesday -- when I wasn't going to be teaching -- I'd be okay at work. I hadn't talked to Weatherwood since Friday, but in the absence of news I assumed things were keeping stable to slight improvement, as they had been. And my boobs were still sore and my eating highly disordered, so I could still pretend I was sort of pregnant, you know?

I slept horribly, though. Shivered down to sleep, then woke up in a sweat: I'd dreamed that Ricky had called to tell me that Nana had died. I lay awake for a long time, then drifted in and out of more bad dreams: nearly losing Miss T. in a train station, over and over.

Then, while it was still dark, the phone rang.

Nana wasn't dead -- and still isn't, so far as I know, as I type on a plane on Wednesay morning -- I just called Ricky from the airport -- but she took a turn for the worse, much worse, in the small hours of Tuesday morning. Her airway is collapsing to nothing. Her oxygen saturation is unmeasurable -- both because it's low and because so little blood is reaching her fingers. She has not been conscious; she shifts slightly, occasionally, and sometimes grimaces. They've given her a little morphine, a little Valium; Ricky tells me the last thing she said on Tuesday morning was that she couldn't breathe. "Her hands are ice cold."

The doctors and nurses have been saying consistently for nearly 30 hours that she only has a couple of hours to live. A priest came in to perform Last Rites yesterday morning.

They do have her on full oxygen now. I think the doctors are trying to decide what a DNR means here; I don't know how much help Ricky is with that. He's been with her round-the-clock since the crisis began.

I spent Tuesday working desperately to get myself free for the rest of the week. I wrote my exams, corralled colleagues into proctoring them, sent flagrantly ashamed e-mail to my classes explaining that I'd be away, here are the arrangements, we'll figure out how to make up the cancelled meetings later... every hour or two I called Nana's hospital room and Ricky told me that nothing had changed. "They are telling us now that it is the TB that's doing all this. Her X-rays looked just TERRIBLE. Now they're telling us that. She does have some pneumonia, but it's really the TB."

I found a miraculous one-way ticket: under $300, to the suburban airport, and only one stop -- 3 hours in Philadelphia! (I could have paid $800 to go via, say, Denver, if I'd been less lucky.) I'll figure out how to get home when -- when it's time to go home.

I scarcely slept at all last night. I'd brought a cordless up to the nightstand, and I couldn't believe it wouldn't ring.

Ricky keeps saying, when I talk to him, that "she's waiting for you to get here, man." He also keeps talking about how "she was the best mother that ever lived, and it was a gift, a gift, that I got to have her for so long."

I won't get an ultrasound on Thursday. I thought about trying to get Cornell to call in an order -- heck, the hospital my grandmother's in has a maternity department, so I could just go downstairs, right? -- but: I know it won't make a difference to the outcome whether I get one or not. So I'm going to wait until I'm home.

Guarded

I talk to either Ricky or Marina every three days or so.

I call Ricky in the late afternoon, as he sits in my grandmother's hospital room. It's an isolation room, with double doors and (I presume) negative air pressure. It feels drafty and she is always cold. If he puts on the heat it quickly gets too hot. He sees climate control, and making sure an appropriate order gets put in with dining services, as what his job is right now, why he's there every day from 10:00 to 6:00.

Marina calls me in the late evening, usually as I'm trying to get Miss T. to sleep. Marina is exhausted. She works all day, then goes up to relieve Ricky at the hospital for a couple of hours. She tells me how frail Nana is, and how bitter; how she tries to refuse treatment, even things that might make her more comfortable. She doesn't think Nana's really about to die -- except for moments every now and then.

Nana is too weak to talk. I haven't spoken to her directly -- my God, since I was there in August, actually. On Thursday night her oxygen saturation went down into the 80's, and they wanted to put on a face mask of 100% oxygen -- she's had tubes in her nose the whole time. She refused, and Ricky supported her. He stayed that night and about four hours later her levels went back up, "after she calmed down some," he says.

They gave her a blood transfusion last week. I think they were planning two, but she spiked a fever after the first, so they stopped.

Ricky has started crushing all her pills into applesauce or pudding, since she was having a hard time swallowing them.

It sounds like the plan now is that once they're sure the drugs are working they'll move Nana into a regular hospital room and keep there until she's stable and stronger. Because of the TB, it sounds like a nursing home is not really seen as an option. When they let her out for real, she'll get 9 weeks of a home aide covered, but no more beyond that.

Both Ricky and Marina tell me not to come now, to protect myself and my family from the possibility of contagion. (They got chest X-rays on Thursday, but haven't heard the results yet. Both will need to be on drugs for a long time regardless, given the positive skin tests.) I never told them I was pregnant, so there's no need to tell them that soon I won't be.

Direct flights from Rust City to the suburban airport nearest to them have been discontinued -- just this week, in fact, and I didn't know until I searched on the airline web page and was offered itineraries that included e.g. eight hour stops in Pittsburgh and cost $2000. Of course I can fly to one of the main New York airports, but that'll be a huge pain, especially since I want to rent a car -- it's hard to see how I'd be useful as a visitor if I didn't, now that they've lost Ricky's free taxi access.

It is, of course, exceedingly unpleasant to contemplate the possibility of starting to miscarry on a plane. From what I've read on line it seems like I'm pretty unlikely to just start bleeding all over the place for a couple weeks yet -- if and when anyone offers me a D and C I'll take it -- but still.

Also, I don't think I should take Miss T. along -- but I don't want to leave her. She's had a horribly scattered couple of months, with the travel for the IVF cycle, and moving to a new room at day care, and Beaker having a couple of business trips, and now Mama being tired and sad, and the stress is showing. She really doesn't need for me to disappear for a couple of days.

So: I am risking not seeing Nana because I don't want to travel. There are several reasons,  all of which should be trumped by the possibility of her dying soon. Yet here I am this weekend in Ohindinois, grading away in my office.

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Directions from Cornell: "Keep taking the progesterone as long as there's a heartbeat." Well, that phrasing makes certain assumptions, doesn't it?

Schrödinger's Uterus

I have been wanting to tell people, this past week. I am tired of living inside myself, of walking around worrying about things only I know about, of holding back.

I have become very aware of how isolated I am on campus. This year's IVF adventures are at least partly responsible: I've been physically gone for all but the most minimal set of job-required activities, and I haven't been telling people why, and I've said so little that they can tell that I'm not telling them why.

My grandmother's health is a generally applicable cover story. But people notice when you don't tell them details. Hey! I told you all about my father's illness and death last year, how I struggled with choosing a home care aide and how long it took to settle the estate! And _I_ told you all about my divorce! Why aren't you telling me about your sorrow? Don't you trust me? (And it just makes it worse, I think, that there's a whole other category of sorrow that I haven't been telling them about at all.)

I have finally been happy, full of a good secret. I wanted to let it out and make other people happy too.

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The doctor located the heartbeat at least 3 times, but didn't say anything for a while. I could hear it, and see the pulses on the screen. That's too slow, I thought. Slower than mine, only like a beat per second.

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What are the odds at this point? I couldn't get a number out of him. I wanted to kill him. What he said in words translated to between 10 and 50 percent chance of miscarriage. His tone, his body language, the way he put a hand on my knee and said, "Don't tell anyone yet," read to me as 70 percent, or higher.

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At 7w1d, growth was normal, or nearly normal (6w5d), but the heartrate was only 67. The combination of normal growth and slow heartbeat seemed to throw the doctor off. "There's only one indicator. Usually we see more than one. Come back in a week and get a scan on the 3D machine. We'll be able to see structural abnormalities then. Sometimes there's a heart block and the rate can correct itself."

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Two questions:

1. This scan saw the remnants of a second implantation, like the first one did. But if there were two implantations, doesn't that mean my initial low progesterone reading (13 at 4w0d) is even more worrisome? (Today's doctor didn't know about that. Would it have changed his estimates?)

2. I've been bad and reading a due-date-club over at MDC. When it gets started this early, there are unavoidably going to be miscarriages. It seems that these often occur, in the non-infertile population, in something like the following way: someone goes in for a scan at 8 or 10 weeks, and learn that the fetus stopped developing at 6 weeks or so. If those women had gotten scans at 7 weeks, would they have seen what we saw today?

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The hospital has remodeled some of its lobby restrooms to "family" restrooms. I waited to use one on my way out. It was silent but locked for a long time.

Finally a short, middle-aged female doctor rushed out; her eyes held sideways, sniffling a long harrumphing sniffle as she went through the door. I went in and looked around the space. If I needed someplace quiet to cry, if I worked there and needed to hold it together the rest of the time, it'd be a fine place to go. Space. Locks. No one would know where you were.

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As I drove back to Granolaton, clouds gathered and it started to rain. Huge drops thwacking on the windshield, like the beginning of a thunderstorm. Ha! I thought. Exactly.

But then the clouds drifted away and, by the time I took the exit ramp into town, the sun streamed through their grey remnants.

Whatever.

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Today's doctor said to stay on the progesterone and come back in a week. I need to confirm that with Cornell, of course. But I made an appointment for another scan next Thursday.

Meanwhile I am pregnant. There is something in there growing. I am not crazy when I feel bloated or tired or nauseous or crampy or cranky. But what is growing is probably broken.

If you read infertility blogs (and if you read this one you must have been reading them for a long damn time!) you know that any bad news at all this early is honestly bad news. I know that too.

I'm not going to ask Dr. Google about this one. It was overwhelming back when when Miss T. measured 6w5d at 7w0d. I'm just going to wait for the next observation.

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Of course I was lying about not asking Dr. Google. And, as it turns out, Dr. Google has a strong opinion.

CONCLUSION: An embryonic heart rate of 90 beats per minute or less early in the first trimester carries a dismal prognosis, with a very high likelihood of fetal demise before the end of the first trimester. Demise occurred in all embryos with heart rates less than 70 beats per minute.