The Recovery: Feelings and Thoughts

Two months ago, on Wednesday, August 14th, I went through with a termination of pregnancy due to a poorly developed baby with hydrops fetalis. I'm not going to go over all the emotional turmoil of it, but I'll say this.

At first, I was devastated and depressed, but seeing babies and pregnant women helped me feel (slightly) better. I wished that, hopefully, at least they would be having healthy babies - at least one of us should, anyway. But as the weeks went by, I realized how difficult it was getting.

After 6-7 months of trying, when I got pregnant in June, I had gotten lucky - four friends and I were pregnant all at the same time! My sister, my friend RS, my coworker O, and my friend Cole! It was a party and great fun thinking of how our bumps would all get bigger at the same time and how we could compare pictures as we go through milestones of our little ones.

But then we hit that bump and lost ours. I became a ghost, a shell of a mom and wife for a month. I almost got fired from my job because of it. And to add insult to injury, I realized that everyone's bumps were getting bigger and cuter. Every single day, I saw my coworker's belly get bigger and I imagined my own baby the same size. My coworker can feel the movement of her baby, and I could imagine feeling that again. My friend RS is going for her anatomy scan soon and I would have as well. Only I'm not. My stomach is still flat and my uterus empty.

I've discovered it's not so easy to watch others get pregnant and stay pregnant when that's all you wanted, and what you had. Their babies will be born around the time mine was originally due. And I'm sure that week will be a tough one for me (the first week of February 2020). Should I do something special to commemorate him/her? I don't know. Maybe I'll take it one step at a time and feel and identify the emotions.

Some of them right now are jealousy. Hope. Unfairness. Depression. A little anger.

And then I think that if/when I do get pregnant again, I'm going to have anxiety about it. Oh yea. I used to think that pregnancy was a super chill, exciting time where you got to watch your fetus grow into a baby with little waving arms and bouncing legs. Though I always knew the risks, my free spirit regarding pregnancy has officially left - it died with my fourth baby. Nope. If/when I get pregnant again, I know what can go wrong, more than I ever had before (and I consider myself pretty well educated). And, of course, I'm "geriatric" now so that changes other numbers that we have to take into consideration.

But in the meantime, we keep trying and preparing for all the High Holidays. And if we're blessed this year, we're blessed. The odd thinking is that if/when I get pregnant, then I'd "know" (I laugh at that verb) why #4 didn't get to stay earthbound. Because we needed this next particular soul to be the one to join us.

I feel like going through this entire thing leads to all kinds of odd feelings. And they're all valid, odd feelings. So I guess I'll take one day at a time, two weeks at a time. Work on increasing my meditation, my breathing, more practice on self-healing and acceptance.

Conveniently perfect timing as we run into Rosh Hashanah and Yom Kippur.

On that note, may we all be sealed in the Book of Life for the coming year. May we be blessed with the things we need and the babies we desire. May we have family, success, and health, and nothing but good news and healthy children.

And on a less spiritual, but no less meaningful note - let's make 5780 our bitch. Light 'er up.

Learning to Let Go...

...and to breathe.

Yesterday was my beloved and my seventh year wedding anniversary and today is the sixth yarzheit (day of remembrance) for my mom - i.e. the anniversary of the day she died in the Hebrew calendar. And, shockingly, this is the calmest I've been in a while.

The end of August was painful - not nearly so as the middle, but I had a blood clot scare and job drama (not yet resolved, but looking good), and each morning I would count down the days until we were scheduled to go to the circus with our littles (on Friday the 30th). Once we made it to the circus, that pretty much meant I survived. Literally and figuratively. I had great belief that once August was over, things would be brighter.

It was sometime toward the end of the last week when my husband joined me in our room and told me that he realized we had NO mezuzot (scrolls) up on almost any of our doorways in our new apartment, and that we had not had any up all month. We moved in the beginning of August.

For those of you who are unfamiliar, there is a distinct and direct connection (whether superstitious or actual) between your health and your mezuzot. They are thought to act as protection over your residence and those within; they are the anti-thesis to evil and a guard over your home.

"The very purpose of mezuzot is the protection of the house and its inhabitants."

My husband is not the superstitious type (I am) so for that to come out of his mouth meant more than anything. We had had a crap-tastic month with no mezuzot. I was quiet and shocked and he immediately said, with great resolve, "I am going to find the mezuzot tomorrow and put all of them up. We need a better month."

And so he did.

Friday was Circus Day and we had a grand time. The kids requested cotton candy (it was larger than their heads) and sat there, astounded, eyes glued to the performance. Every so often, one of them would turn to us and say in their little voices, "What in the WORLD was that!?" It was magical and still brings a smile to my face.

Immediately after it ended, I realized my phone and wallet had dropped. It's still August, I thought, devastated, knowing that Shabbat was about thirty minutes away. Security couldn't find it. I couldn't find it (even with fifteen minutes of intense searching with a baby on my hip). My husband then went to find it and came back with it in hand. RELIEF!

We walked home quickly, lit candles, ate our Shabbat meal, put the kids to bed, said our gratefuls, one of which was celebrating the end to one of the worst months of our lives.

* * *

The next afternoon, after missing for at least six months, I found my engagement ring. Randomly, on the floor, laying and twinkling at me just inside a cabinet door, like the planet hadn't just shifted beneath my bare feet.

I blinked and gently picked it up. I turned it over. It wasn't my imagination - it truly was sitting in my hand, sparkling and reflecting more than seven years of love.

Over a month prior to moving, I had shared my worst fears with hubby, that my ring was lost forever. I was even ready to says the blessing for recovering lost items (like I said, superstitious), but my husband had faith it would turn up - even dreamed that it would be found before our anniversary.

And so it did! And, yes, I've been wearing it every day since.

Immediately after finding my ring, I jumped up, ran into our room, leaped onto the bed, and woke my husband with a huge smile on my face. He shared in my joy and calmly said, "you know, it's also Elul (a new Jewish month)... and Monday is our anniversary."

I could have cried with the sheer relief of it all. The weight suddenly lifted off my shoulders.

So who cares that we now have to get up and take three kids to three separate Ganim? Who cares that we now have parental meetings and all sorts of extracurriculars to handle? Who cares that I'm remembering my mom's passing at the same time as celebrating my marriage? NOT ME.

My mom would be super happy for me. She met my husband and loved him as a match for me. She saw the ultrasound of my first baby and loved the perfect shape of his head. I have an amazing husband who takes me to the beach at night to celebrate seven years, with wine and cheese, fruit and dip, and crepes with chocolate and jam. I have three ridiculous children who smile and scream with delight every time I come home from work. I live in a lovely neighborhood with really kind friends nearby who honestly care about me. I get to keep up and share videos and photographs with my friends and family regularly because of technology. I may not be financially wealthy (yet), but I am rich because I have a full life.

It's not perfect and I'd like another baby (healthy!), but today, at the beginning of September, Elul, and the rest of our lives, I'll take it.

Trust, lots of trust, and a little anxiety on the side.

Thursday, August 29.

I woke this morning with a lot of anxiety.

A year ago, when I was re-diagnosed with depression, I was "lucky" enough (haha) to also get its accompanying 'kissing cousin,' a.k.a. anxiety. I had never really had anxiety before, but I have plenty of friends with anxiety disorders. I could always sympathize, but never quite empathize until now.

Over the past year, I've had good reason to be anxious about things, but, see, the thing about anxiety is that it doesn't always make sense. I remember this past Spring my husband telling me that he finally bought me and my baby daughter the tickets to America we'd been talking about so I could go see my dad; I literally had low-grade anxiety the entire day before bawling and freaking out once I walked in the door. He didn't quite understand and I had to explain. It wasn't that I didn't want to go, I said between tears. It's just ... big. A lot.

Time has passed and I've had a rough August. A really rough "f*ck you" kind of August. We moved, had all three kids off school/gan, commemorated my mom's English date of death, learned our thirteen-week old fetus wasn't healthy and had to make the choice whether to terminate the pregnancy, had to maneuver the hospital system to finally get it terminated the next week, studied and took two legal exams to become licensed in Israel, celebrate what would have been my mom's 79th birthday, and then get a scare that my blood clots (from ten years ago) came back.

To add to all the physical and emotional drama that I endured this month, there was also an intense amount of job drama as well. I'm pretty sure it'll resolve this week, but that's a lot of additional anxiety to heap onto my already formidable depression that I'm carrying on my shoulders.

In my attempts to resolve this job drama, I had to speak with my boss and share some personal information from this past horrendous month of August. She was sympathetic but told me that I need to trust a little more.

While processing my experiences this month, I had some (very brilliant) friends and family check in and share with me what they believed were insights. They were legitimate. Both involved trust.

My husband, while I was explaining my feelings and what was happening around me, said simply, "I guess Talya needs to learn trust."

In the span of three days, four separate people told me that I needed more trust.

But, in the past, when your boss fires you the week you're sitting Shiva for your mom, you've had your best friend suddenly accuse you of stealing her $15,000 engagement ring and file a police report against you for said accused felony (and never apologize once the ring was found), you've had boyfriends cheat on you, you've had family (temporarily) turn on you, and most recently, your body fail you, how do you regain that trust in anything? In others, in your workplace, in your body, in life, in G-d?

I can't simply "unexperience" this crap, I can't "unsee" or "unfeel" any of it.

But here's the food for thought that was provided to me - do with it what you will:
The opposite of anxiety is not tranquility. Nor is it peace, clarity, calm, or serenity.
The opposite of anxiety is trust.

When we are anxious, we are not trusting in ourselves, in G-d (if you believe), in others, or in things to pass.

In Hebrew, "worry" is "דאגה"
It has four out of five of the first letters of the Hebrew alphabet. The missing letter is "ב."
When we worry, we're missing בטחון - the trust (the security).

So I'm going to consciously take a leap and make an effort to trust again. Myself, others, and G-d ... How the hell do I do that? I guess by taking one step at a time: accepting emotions, meditation, visualizations, exercising/sleeping properly ...

לאט לאט.

Perfect Soul, Imperfect Baby: That Day and Beyond

Part VI: Thursday, August 22.
That Day and the Emotional Aftermath.

On Wednesday the 14th (an inauspicious day in my family), my husband and I woke up too early (not really, I slept through the first alarm at 5:30am) and snuck out to drive to Assuta in Tel Aviv by 7am. No one was awake in our house, not my husband's brother, not the baby, not the boys. My sister-in-law had also slept over so she could get a ride into TLV, but she was very quiet as well. What was there really to say?

We drove in, throwing small talk occasionally at each other, but mainly, I was nervous and quiet. I didn't really know what to expect physically or mentally. I won't go into too much detail, but the nurses and doctors at Assuta were extremely professional and kind (thank goodness). I got a lovely ventilated gown to wear during my stay, two stylish bracelets, and autographed several documents stating that I was aware of the risks and complications that could occur - standard run of the mill stuff, like a punctured uterus or retained placenta. I was nervous as hell and took prayers from whomever and wherever.

My first two births (my crazy boys) were drug-free but induced since I was on blood thinners and the doctors and midwives were nervous. In both the States and Israel, I took a half a cytotec pill orally and my body, apparently knowing what it was doing, simply took over. My third baby (Lil' Lilush) was all drug-free, no cytotec or anything. This fourth baby required a little more.

While sitting with the doctor discussing risks, he gave me FOUR cytotec pills, two to take sublingually (under my tongue) and two... elsewhere. I remember thinking it was overkill - what a terrible choice of words. But there's nothing "choice" about this "procedure." The most random thoughts go through your head when you're laying there, waiting for the pills to kick in, freezing, teeth chattering due to incoming wacky hormones and air conditioning, counting down the sixty minutes before they take you in.

And then they do.

They wheel you in through a set of double doors that requires one scanned card and then another. The doors in front of you don't open until the set behind you closes. I think, how odd it is that they have safari doors - what, they're afraid of crazed, pregnant women breaking out of the department, gowns flapping in the wind as they wave their hands in the air... Like I said, random thoughts.

My husband walks with me as far as he can go, grips my hand, tells me he loves me, and then I'm alone and it's freezing in the interior hallway. The hormones have jacked everything up and it feels like I've been here forever, but it's only been an hour since I took the pills. The kind nurse asks me again what my ID number is, and I crack and almost cry as I repeat it to her. It's too late to change my mind and I can't anyway - there's no point.

I'm asked to walk into the OR on my own accord and I do, chattering the whole way. The nurse gets me not one, but two heated blankets, one for beneath, one for above (it helps a little) and they prep me, give me a quick IV with antibiotics and an anesthetic and say, lilah tov.

...

And that's it. I wake up in recovery, empty. I sleep and sleep some more until they finally let my husband in. I sleep more and they wheel me back into my original room. I have to lay in bed for a total of two hours and ding them when I need to use the bathroom (kinda like after you give birth). So I lay there.

I don't remember what I spoke to my husband about except that I was hungry. We headed to Ra'anana and my in-laws suggested eating at this great place called Sara's Place. I wasn't really in the mood, but we went and I'm glad we did. With all my remaining energy, we ordered the best hamburgers and we talked. He mentioned that the nurse came in to the waiting area after my procedure and asked who was "Ariel haGibor (Ariel the hero)." Apparently while I was coming out of sedation, that's what I called him. We sat next to each other, we enjoyed our food, we shared photos of the kids, and we enjoyed each other's company thoroughly while trying to move forward from the hellish morning.

I don't really recall much after that. I hadn't realized that lunch took the entire week's energy. I'm pretty sure we went home and I rested. Slept and rested. Slept and rested. Played a bit with the kids as a pick-me-up and then rested more. Rested all of Thursday. On Friday we started studying for my first law exam. On Saturday, my oldest asked me when the baby was going to join us. On Sunday, I took my exam. Monday and Tuesday were "work" days, and Wednesday I studied again. Today (Thursday) was another exam which ended around 3:15pm and in three days, we will try and celebrate "Mama Chana" day (what would have been my mom's 79th birthday). Quite the month.

I haven't had much time to think about everything that happened over the last two weeks; all I've been doing is coughing, studying, and taking tests. Today, the last test for five months, has been the day I've been dreading - wondering if it would be as bad as the week after shiva ended. Truth be told, I'm in a foul mood, I'm sad, and I'm tired. Over the past week there were some days where I couldn't stop crying and there were some days when I was just... tired and disconnected. One guy at work kept asking what was wrong and I just didn't feel like sharing and voicing everything. See, writing is safe. Speaking is not.

It's getting harder and harder to write these articles. It's getting harder and harder to share how I'm feeling. It's getting harder and harder to think of the little baby and feel these things and I so badly just want to tuck them away. And sleep. A lot.

I don't really have a choice though. As a friend said, the sun comes up every morning whether you've coped with the day or not. I guess I'll just do my best, wipe my tears, play with my three little miracles and my husband the hero, and maybe, one day, my sun will come up, shine through the tears on my face and I'll get a rainbow.

Just not today. Maybe tomorrow.

Perfect Soul, Imperfect Baby: Swirling Thoughts

Part V: Tuesday, August 13.

My Swirling Thoughts.

Each morning for the past week (yes, it's been a week) I've struggled to get out of bed. In my everyday life since last August when I got re-diagnosed, I have suffered from depression. To combat it, I take anti-depressants and until now, they have been a life-saver. I also happen to have a sleep disorder; for this, I take sleep medication nightly (except for the nights before the days I think I'm going to have a "procedure," which isn't really a procedure, but rather the termination of a life that, apparently, wasn't meant to be). 

This week, however, was a doozy and the depression really kicked it up a notch. My husband shared with me last week that he was concerned for me and my mental health. Yea, nodding, I could see that, but I'll be okay. I'll write and write and write some more. Maybe I'll paint. Maybe I'll do more photography. Maybe I'll vomit.

I go to work because why not, what else am I going to do. So I arrive and it appears, from the outside, that it's a regular morning at my regular desk with the regular Mediterranean Sea outside my window.

From the inside, it's all turmoil. My thoughts center around this sad, broken little life still growing inside me. I just want to get past this already (whatever "this" is), and I'm glad it will finally be tomorrow. At the same time, I'm dreading it. Kinda like a funeral, I guess. You know you need to attend and you know it's going to suck, but you also know you might, possibly, start to feel some closure after it happens (or at least you hope so).

I draft and share my very first article about it, sharing my baby and my story with the world. Before this moment, very few people knew and, suddenly, everyone knows. The wall cracks and crumbles before me.

Everyone comments on my bravery; they message me privately; they leave messages of love and light to break through the darkness surrounding me; they send me WhatsApps. 

Women from Michigan, Israel, other cities and countries come out of the woodwork to flood me with love and stories; women I know, women I don't know, women who publicly share their experiences, women who have never told anyone about their loss. I hear from other women who (and a husband whose wife) went through something similar. 

They offer to chat, to listen, to sit next to me, to attend the procedure with me. It's incredible, a little intimidating, and very humbling. It makes me cry that (unfortunately) I am not alone though my situation is slightly different than most, me with a still-alive baby.

Here's what's not fair about this, aside from everything.

• I'm still nauseated.
• I still have cravings.
• I still take my folic acid and prenatal vitamins.
• I still am scared to drink alcohol even though it's completely and logically moot at this point.
• I feel guilty and relieved that I'll probably physically feel better after this is done.

Lunch is relatively "normal" and I find it surreal that this is my "new normal." 

It's only after lunch, as I start to think again, when I start to feel awful and queasy about the whole thing, even though I know, intellectually, it's the right decision. And that's part of the problem. Your brain says one thing and your heart wants something else.

The problem is that I was given way too much time to think about this.

The problem is that this happened at all and I will likely never ever have an answer for any of it. 

Hydrops fetalis happens. It's rare, but it happens. Only a tiny percentage of hydrops babies are miracle babies and mine, with its chromosomal abnormalities, defects in the umbilical cord, and possible and potential other bodily defects, is simply not one of them that had a chance.

But maybe that's a good thing. 

In a warped way, this could have been worse. The baby could have been given a tiny chance on which I would have had to wager. And, in all likelihood, the baby would have died somewhere between twenty-two weeks and birth, if we were lucky. When all this started, I joined a hydrops support group and I cannot tell you how many pictures I have seen of parents tearfully saying 'goodbye' to their little babies. Ironically, each picture made me feel better about the choice we were making.

Despite all this, the other thought endures. If I had to have a malformed fetus (the worst pairing of words in existence), why couldn't my body just manage to have a "regular" miscarriage? 

Why do I have to make this awful decision and sit with it for almost a week before being able to follow through?

How did this little fetus even get to this point of development... sheer stubbornness??

None of this is fair. Not even remotely.

Perfect Soul, Imperfect Baby: Protectzia

Part IV: Monday, August 12.

Protectzia

Instead of waking up at 6:00am and leaving the house within a half hour (sneaking out before the kids wake up) to head to Haifa, we play life as usual and pretend everything is normal. I put my eighteen month old on the back of my electric bike (teddy bear helmet, motzetz, and all) and take her to her Gan, her sucking on her pacifier the whole way, a smile on her face in the wind. Today, instead of accompanying me to my procedure that I should have been undergoing, my husband stays at home with two happy boys, waiting for a call from Maccabi, waiting for the peace of mind we've been seeking for days. 

For whatever reason, even though Ariel was the one on the phone with Maccabi all day, he didn't get the call that morning. Even though he was the one who spoke to nine different Maccabi representatives who each gave different information as to how long the process would take, when we'd receive the document, even how the process worked, he didn't get the call. Even though they promised to call him the moment it was approved and sent through, he didn't get the call.

He didn't get the call, but I did. I receive it by the time I'm on the train to work, late, at 9:00am, long after the "procedure" was scheduled at Rambam in Haifa. I immediately let my husband know he should call the hospital for an appointment the following day (Tuesday), thinking it was no big deal. He calls them, then calls me back. "Are you ready to be upset?," he asks. I hesitate, but nothing will surprise me at this point.

Apparently, they will no longer perform a D&E for me. No reason given. Perhaps it was because we were a "no-show" that morning, perhaps they didn't want to deal with Maccabi (I can't really blame them) - who knows. Either way, though they were more than willing to squeeze us in the last few days, it doesn't help us now.

Over the next several hours, we have no choice but to call different hospitals to see who, if any, will still perform a D&E at 14-15 weeks. My husband calls our amazing specialist (remember Dr. Drugan?) for a recommendation, then calls four different local hospitals. Some (Ichilov) don't bother answering, make him wait for forty-five minutes on hold before deigning to pick up the phone, and promise a call-back (which doesn't happen until after 5:00pm - and, by the by, they then inform us that they require their own, new, Committee hearing and finding). 

Another, Asaf HaRofe, accepts our situation, Committee finding, and Tofes (apparently they perform D&Es until twenty-something weeks), but they have a two-week waiting list. Ariel tries to call Assuta next, but can't find the right number to the proper department. My husband then calls Tel HaShomer, who was actually great. They answered the phone within seven minutes, listened to our situation kindly and carefully, and promised a call-back (and DID SO within an impressive thirty minutes - though luckily, by that time, we had already solved our issue).

While my husband is busy with the phone glued to his ear, I'm spewing my heart out about this emotional and tiring situation with my office-mate, now friend. She mentions, casually but quite seriously, that her father works at Assuta in Tel Aviv and asks if I want her to call him on my behalf... Yes. Absolutely, I say.

See, I'm no dummy. Elbows and patience aside, I know how this country works ("protectzia") and I never ever say no to these offers (if you're smart, you won't either). She calls him for me, he gives her a specific name and phone number at Assuta, and I pass the information on to my husband. He calls them back.

Within twenty minutes and just before high noon, I have a D&E scheduled at the beautiful (private) Assuta in Northern Tel Aviv for two days from now at 7:00am.

My heart stops. I am thrilled, but extremely cautious.

My husband is too. He confirms with Assuta that they will accept my Committee finding as well as the long-awaited Maccabi Tofes 17 that I've finally received for the other hospital. 

Not a problem, they said, practically waving their Israeli hand over the phone, they are partnered with Maccabi and, for them, I never needed a Tofes in the first place. All I need is my little plastic Maccabi ID card and paperwork. That's all. We never needed one for them and not one of the nine Maccabi representatives ever mentioned that option.

And that's all. Just like that, it's scheduled.

I thank my office-mate profusely. She shrugs it off, no biggie. It was just a phone call, she says (so Israeli).

I argue (so Israeli). Just a phone call for you, I insist (and note in my head that I will forever bring her strawberry flavored taffy).

But just a little paranoid, my husband calls Maccabi again to verify that the Tofes 17 will be accepted. Again, it is confirmed that it will be, but seriously, Assuta doesn't need it. We're good to go.

So... Wednesday, August 14^th will be the big day. Deep breath.

The end of a beginning.

Perfect Soul, Imperfect Baby: The Absurdity

Part III: Sunday, August 11.

The Absurdity. 

Today is Tisha B'Av - a national mourning (and fasting) day for Jews. As usual, we took our 18mo old clever, gorgeous little girl to Gan for the day and left the boys with a babysitter and my husband's sister, who came out special to help us. 

We headed north and arrived in Haifa just before 10am so they could squeeze us into their schedule. I was 13w+5d and though we arrived on time, it didn't matter one whit since Maccabi hadn't yet sent us the mandatory Tofes 17.

I had been fasting since midnight in preparation for the surgery this morning but nothing doing. We found the proper floor, signed in and my husband and I sat in the waiting area while we waited for this document that, apparently, was never going to arrive. The nurses, with kindness in their eyes, were ready to take me back in an instant, knowing what I was going to undergo.

We (that is, my Israeli husband) called Maccabi every hour upon arrival and, right away they told us that, oh, we’ll mark it urgent for us (never mind that they had already said that on Thursday afternoon – remember that?) and it would arrive within the hour (but remember, we're already at the hospital waiting).

We wait and call in another hour, oh, they exclaimed, we'll mark it extra urgent and you'll get it in an hour! I put my head on the table. 

Still, nothing but disappointment. At this point, I'm still fasting, but now I'm lightheaded and it's noon. At one point, the nurses rush me back to squeeze me in but as we approach the back, they realize the document had not, in fact, come in, and apologized profusely as they brought me back to the waiting area. I got nothing but sympathetic faces.

It's now after noon and the hospital can no longer fit us into their schedule. I’m emotionally and physically empty but for my uterus.

After giving us an appointment for the very next morning (Monday) at 7:30am, Rambam Hospital sent us home, provided, of course, we got the Tofes 17 in time. My husband continued to call Maccabi every hour, including when they were closed to the public from 12-4p (cushy job), and they kept promising that we'd get it. In response, my husband kept telling them he didn’t believe a word they said. He kept calling and calling and told them, NO, we already missed our appointment this morning, we have a new appointment tomorrow at 7:30am, and we can't go if we don't have this document. Despite all their promises, despite all our pleading, their office closed with no Tofes.

So what do we do, my husband asks me. I shrug. I am emotionally spent. It's enough that I'm still growing a baby who won't live. It's enough that I (we) must make this choice at all. It's enough that I have to go through this “procedure.” Now we have to fight with my kupa about getting it done, in time, so I don't have to be induced and give birth.

But big surprise…. Maccabi hadn't come through and I have no energy whatsoever to go to Haifa again, much less at 6:30am without a Tofes or any guarantee that the hospital can do the procedure. Not to mention figuring out how to get the little one to Gan... so we cancel my husband's brother for the next day and say we'll wait. I guess we’ll just wait for the Tofes and I'll go to work.

I still don’t really feel like telling anyone or talking to very many people, but I finally tell my good friend in Netanya what's going on and, just like my other friends and family, she hurts for me. She asks what she can do. Nothing, I said. There’s nothing you can do. But she doesn't listen. Instead, she sets up a meal train for me starting on Tuesday. People will bring over food for my family and me so I don't have to worry so much about recovering and moving around. She surprises me with a bottle of wine and my favorite snack: salty pretzels and Duncan Hines cream cheese frosting. I actually smile, hug her tight, hurry inside to put my kids to bed, break the fast, and eat my beloved pretzels and frosting in the living room.

It's now evening on the day this was supposed to happen and it’s finally quiet in our apartment. My husband and I sit next to each other in quiet. He watches a show on Netflix. I watch a different show. I think, "I still have a baby."

We turn off our shows and study for my law exams that are scheduled for next week.

We go to sleep.

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Perfect Soul, Imperfect Baby: The Confirmation

Part II: Thursday, August 8

The Confirmation.

Early this morning, without an appointment and under advisement from our ultrasound doctor, we slipped into Dr. Feldman's office (our ob/gyn) to get a consult with him about the results. He's a very reasonable fellow, knowledgeable, speaks English, has a good bedside manner, and very clearly cares about his patients. Out of all the gynecologists in this country, he's my favorite. My husband and I sat down, not expecting good news, and, sadly, he obliged. 

He looked at the ultrasounds, paperwork, and detailed information and was extremely apologetic. When a doctor looks at things, what you want is "unremarkable." That's not what we got. 

He gently gave us advice and choices, sad smiles, and told us that it was likely serious chromosomal defects in the fetus, who would likely not survive even until birth. Quietly, he suggested we should terminate. I already knew the answer, but I asked quietly if it were fixable - maybe I had made a mistake, maybe I had misunderstood the research I had done, but he shook his head and said, no. I started crying again. 

Dr. Feldman said what we could do is get additional information by calling his friend, Dr. Drugan (a genetic specialist) at Hillel Yaffe Hospital in Hadera. Honestly, he said, we could just drive up there and see if he'd see us in person since it's only about 25m away. 

My husband and I looked at each other and immediately drove to Hadera. Parking was a little difficult with all he construction, but then we walked into the beautiful hospital that had huge (fake) birds flying in the expansive foyer. We wandered around until we found Dr. Drugan, and, surprisingly, he accepted us for a quick consult - again without an appointment - when we told him it was urgent. 

He sat us down, looked at the information, and shook his head. He gave us the same information as the other two doctors, that not only was it likely that the fetus wouldn't survive to birth, but also that I could miscarry at any time (which may explain my constant cramping). The specialist told us we had two choices: we could either end the pregnancy immediately with a D&E or we could get a CVS/amnio to see the reason for the chromosomal defects (and then get a D&E). We did have to keep in mind that test results could take up to a week, even expedited, which could then affect what type of procedure I might have to undergo.

Dr. Drugan mentioned this specifically because his hospital, Hillel Yaffe, conducted D&Cs only until thirteen weeks. Rambam Hospital in Haifa performed them until fifteen weeks, but either way, I was past the 13 week mark so I had to decide quickly if I didn't want to be induced and take two days to give birth to my malformed baby.

I couldn't decide about the CVS sitting right there, but the doctor gave us time. My husband and I used it to eat lunch, our first meal of the day since we had been running around. We decided, after great deliberation and reviewing the fact that additional information would not help with future pregnancies, that it'd be best to handle everything sooner rather than later. It was likely just a fluke at my age. We returned to Dr. Drugan, again without an appointment, and told him that we'd like to go ahead with the D&C. 

He immediately took his cell phone out and called his contact at Rambam Hospital, scheduling the procedure for Sunday morning at 10am (they were basically squeezing us in). He also scheduled us to be heard, that very afternoon, by the Committee who grants terminations of pregnancy (he is on the Committee). We ran home, helped our babysitter with clothing and lunch (we had just moved the previous week and she couldn't find clothing) and returned to Hadera in time to be "judged." We filled out paperwork in a broken down little building (I think the Hospital was rebuilding every other building first), met with a highly sympathetic social worker and a very understanding Committee (who must have at least three people: a social worker, a secretary, a genetic specialist, and an internal doctor). Without hesitation, they approved our termination and literally wished us love and good luck in the future.

That's when the trouble began.

Immediately (remember this detail for later) upon leaving the hospital to head back home, we called Maccabi (our health kupa whom we usually love) and told them we need a Tofes 17 – a document that shows the kupa the procedure has been approved and it shows the hospital that the cost of the procedure will be covered, in this case, a procedure that costs over 4,000 shekel. We informed the kupa the urgency of it and that we would need it by Sunday. They claimed they marked it urgent and we would have it in time, an important fact since the hospital would not go ahead with the procedure without it. 

This day had been filled with running around, meeting with doctors, paperwork, and appointments. It was all mental and logical. But the weekend.... the weekend was all emotional.

All weekend I prepared myself mentally for Sunday morning. On Friday, I spent time with my three kids. On Friday night, I asked my husband to give one last blessing to the baby (and cried through the whole thing). On Saturday, I didn't want to talk to anyone and slept late, and on Saturday night, I rubbed my belly, felt my uterus while lying down, and told the baby it was loved and that I was sorry. 

And while I slept, I dreamt of my baby.

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Perfect Soul, Imperfect Baby: The News

Part I: Tuesday, August 6. 

The News.

It's amazing, nay, MIRACULOUS, how many biological things must line up just right in order to get pregnant. They say that even if you time everything perfectly with ovulation, there's only a 25% chance that the egg will get fertilized. After that, assuming the fertilized egg implants properly in the uterine wall, there is still another 25% chance that the pregnancy won't end successfully and there will be a miscarriage. Again, that does not include any pregnancies with developmental or health issues. So, in essence (assuming my math is correct), there is only an 18.75% chance that you'll have a complete pregnancy and birth a baby from each time that you try to get pregnant. Now, most babies are born healthy. In fact, 96-97 out of every hundred babies are born healthy, but that means three or four of each hundred have some type of birth defect. This further affects numbers, reducing the likelihood from 18.75% to 18% that you have a healthy baby for each time you try to get pregnant – and that's not considering other individual factors like family history, biology, or age.

I have three beautiful children, ages five and a half and younger. My two crazy boys and my crazy little girl. And we want a number four.

I got married relatively late, at thirty-four years old, and so my husband and I started trying for kids only four months married. I always tell couples that if they have the luxury of time, they should most definitely get to know their spouse before starting the baby-making since it's not an easy path to follow. And so far, we've been lucky. We were three for three in the span of five and a half years. Until now.

I haven't had a good feeling about this pregnancy the entire thirteen weeks. I've been more nauseated than usual, cramping more than usual, my skin was more messed up than usual… all relatively minor things, but at about seven weeks, the ultrasound showed the baby disconcertingly small though it did have a heartbeat. We then came back again at nine weeks.

My bad feeling continued. Each time I went to the bathroom, I would expect to see red. I dreamt of it. I was having so many cramps for what I hoped was a regular pregnancy, but I figured I was overthinking things and simply didn't remember all the details of my previous pregnancies. It happens. And at the nine-week ultrasound, everything appeared to be okay so we scheduled the nuchal translucency thirteen-week ultrasound for the morning of August 6 – three days before the anniversary of my mom's death six years ago and five days before Tisha B'Av (the national day of mourning for Jews).

The boys were home with a babysitter, the little one was at Gan, and we came in. The ultrasound doctor first completed an external scan to measure the nuchal translucency fold behind the neck, but things didn't look so great. It was very thick, almost 9mm (it's supposed to be 2mm or less), and there was fluid around the baby's stomach as well (should I say fetus instead?). The doctor seemed very serious and switched to an internal scan to get more measurements. The baby didn't seem fazed by all the activity, lightly dancing around the screen. The scan ended, my husband occasionally taking pictures of the ultrasound.

Years ago, I had assisted my best friend in studying for her ultrasound exams (she's now an experienced tech in the States) and helped her learn to identify all the body parts in a scan, what measurements were supposed to be, what a healthy scan looked like, etc. I looked at our scan that was on the monitor and something didn't look quite right.

We finished and the doctor turned to us and said bluntly, "that wasn't a good scan."

At first we misunderstood. Did we need to come back in a week? Was the baby not cooperating? Again he said to us, "that wasn't a good scan." He went on to explain that there was a lot of fluid at the back of the neck and around the baby's stomach. The blood flow inside the baby's stomach wasn't right either. Basically, he was certain there was a 90% chance that this wasn't a healthy baby and wasn't a healthy pregnancy. He gave us permission to end the pregnancy and said that anyone who saw the results of the scan wouldn't question it. He told us this information while the internal ultrasound wand was still inside me.

While I was laying there.

While my husband sat next to me.

While we were looking at this little thing bouncing on the black and white screen.

The physician told us that he'd explain further at his desk so I cleaned up, stunned, and my husband and I sat together opposite the doctor. He had to finish typing his notes first, so I sat there, listening to the hunt and peck of his fingers on the keys, each one sounding like a stick on a drum echoing in an empty orchestra chamber changing the rhythm of my life forever. He typed out his notes for what felt like forever and I knew I was disassociating as I listened and watched him hunt and peck for each key, tapping out a word, making a sentence. Another sentence. Tap tap tap boom tap tap tap… tap boom.

Tap tap.

BOOM.

Again he told us the results and explained that we had two choices. One was to end the pregnancy immediately; the other, to speak to our ob/gyn and get information on additional testing at the hospital with a CVS or amnio. Either way, we should act quickly, but we should know that it was definitely at least 90% likely that it wasn't a healthy baby. He was sorry, he said remotely as if suddenly remembering to be human… this must be a bolt of thunder on a clear sky (Israeli idiom). He folded up our paperwork and pictures, slid them into an envelope, handed them over, and that was it. I stood, stunned, with wet eyes, shook his hand professionally, and walked out.

From that point forward, all I have seen are strollers and babies. Pregnant women and little kids. I know I have three healthy kids at home and I'm feeling very lucky. I haven't told very many people since I'm still absorbing and processing all this, but here are some of my initial thoughts:

• I don't want your sympathy.
• I don't want you to tell me that "a not-healthy baby is still a baby." Maybe I didn't express myself well since I was still absorbing the news, but I'll be lucky if the pregnancy continues past 22 weeks or I don't miscarry tomorrow.
• It is not your news to tell anyone else.
• No, I don't want to talk to anyone.
• I know myself and I mean it when I say that the more I know, the better I feel about it (i.e. let me do my own medical research online).
• I do NOT want to hear that women my age have increased dangers – I am well aware of the statistics. And statistics are just that, until you are the statistic.
• It feels so surreal.
• I am a statistic.
• Leave me alone.

My husband and I are stunned. He is angry at the bedside manner of the doctor. He is upset because he hadn't quite gotten used to the idea that I was pregnant and now, it was suddenly stolen away. I am... I don't know... stunned. Up and down. Disconnected, upset, quiet. In disbelief. Laying down, I can feel my uterus and I know that there's a tiny little life in there. It seems surreal and incorrect that this little thing is unalterably broken.

What I discovered on my own (yes, Google can be helpful): Without using particular medical terms, whether it was because English was his second language or that he simply didn't want to use it, my baby has a really bad case of non-immunehydrops fetalis, a rare and serious fetal condition defined as abnormal accumulation of fluid in two or more fetal compartments (usually the neck/head and stomach). When it is diagnosed as early as it was in my baby, 12-13 weeks, the vast majority of the time (75%) it is due to chromosomal abnormalities. See, hydrops, as it is called, is not the cause of the problem, but rather the result of an underlying issue. In my baby, in addition to hydrops and the likely severe chromosomal issue, the umbilical cord is connected to the baby in the wrong place. Instead of going through the shunts that babies have/need since their systems aren't developed yet, the cord is connected directly to the IVC (inferior vena cava), which, medically, means that the faulty system is, and will, negatively affect filtration of the blood as well as oxygen to the liver.

Altogether, Superbaby or Nougat (as we fondly like to call it), ironically, did an excellent job of doing a crappy job of developing properly. My kids do nothing halfway. How lucky we are.